Is the use of marginal donors justified in liver transplantation? Analysis of results and proposal of modern criteria

Transplant International : Official Journal of the European Society for Organ Transplantation
L De CarlisD Forti

Abstract

A discrepancy exists worldwide between the number of suitable liver donors and the increasing demand for transplantation. Thus many centers have considered widening their liver donor acceptance criteria and this may increase the incidence of primary dysfunction (PD) with negative effect on the results of transplantation. In order to reduce the incidence of PD and improve patient and graft survival it becomes important to identify those risk factors associated with its occurrence. In a retrospective univariate and multivariate analysis we evaluated several donor, preservation and recipient parameters and their correlation with PD. In our Department 282 orthotopic liver transplantations (OLT) were performed on 256 adult patients over a 10-year period. Excluded were 15 cases with early vascular problems and 4 intraoperative deaths. A complete series of donor, recipient and procedure-related data were analyzed. About 30% of donors showed abnormal values. In 70 cases of PD (26%) there was a 61.4% graft failure rate compared with 15% in the group with immediate function (P < 0.05). Univariate analysis showed donor age, steatosis, ischemia time, amines, oliguria, hypotension and ICU stay to be significantly associated with PD. Multiva...Continue Reading

References

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Citations

Feb 12, 2008·Transplantation Proceedings·H SözenA Dalgic
Jun 20, 2009·Clinical Transplantation·Arianeb MehrabiJan Schmidt
Jan 29, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·L LantieriP Grimbert
Aug 4, 2006·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Federico CasaleMauro Salizzoni
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Aug 20, 2008·São Paulo Medical Journal = Revista Paulista De Medicina·Telesforo BacchellaMarcel Cerqueira César Machado
Sep 10, 1999·Transplantation·H V Melendez, N D Heaton
Sep 7, 2004·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Xian Liang LiSheung Tat Fan
Jun 27, 2003·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Ronald W Busuttil, Koichi Tanaka
Nov 7, 1999·Transplantation·R B FreemanF L Delmonico

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