Rescue allocation for liver transplantation within Eurotransplant: the Heidelberg experience

Clinical Transplantation
Peter SchemmerJan Schmidt

Abstract

Organ shortage has driven many transplant centers to extend their criteria for organ acceptance. Graft allocation policies have been modified accordingly. This report focuses on the impact of applying the so-called rescue allocation (RA) strategy for liver transplantation (LT) in a single center within the Eurotransplant (ET) area. Liver grafts are considered for RA when the regular organ allocation is declined by at least three centers or is averted because of donor instability/unfavorable logistical reasons, thus entering a competitive or a single-recipient rescue organ offer procedure, respectively. The accepting center has the advantage to select a recipient from its own waiting list for these RA grafts. Among 253 livers accepted at the University of Heidelberg between January 2004 and December 2006, we transplanted 85 (34%) rescue-allocated livers. The indications for LT were hepatocellular carcinoma (HCC, 43%), chronic liver disease (55%), and acute liver failure (2%). Median cold ischemia time for RA grafts was 10 h (range: 4-17). The MELD score (mean +/- SD) was 13 +/- 7 (range: 6-40) and was 12 +/- 7 for recipients with HCC. Three (3.5%) primary non-functions (PNF) occurred after transplantation of RA livers. One-year ...Continue Reading

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Citations

Jul 10, 2013·Transplant International : Official Journal of the European Society for Organ Transplantation·Anne MossdorfChristoph Heidenhain
Jan 27, 2011·Transplant International : Official Journal of the European Society for Organ Transplantation·Leo Roels, Axel Rahmel
Dec 20, 2013·Liver International : Official Journal of the International Association for the Study of the Liver·Dieter P HoyerZoltan Mathé
Nov 20, 2014·Transplant International : Official Journal of the European Society for Organ Transplantation·Melisa DirchwolfFederico G Villamil
Mar 27, 2015·Langenbeck's Archives of Surgery·Christa FlechtenmacherPeter Schemmer
Jan 4, 2018·Transplantation·Giovanni GirettiEphrem Salamé
Aug 18, 2010·Scandinavian Journal of Gastroenterology·Axel DoeneckeAiman Obed
Jul 21, 2020·Clinical Transplantation·Yuki KitanoRené Adam
Jul 23, 2020·JHEP Reports : Innovation in Hepatology·Audrey WinterCyrille Féray

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