|
Am Surg 1998 Aug;64(8):785-790
Donor liver selection. The South-Eastern Organ Procurement Foundation
Liver Committee.
Broughan TA, Douzdjian V
Department of Surgery, The University of Texas Medical Branch, Galveston,
USA.
Changes in donor liver allotment will not generate more organs. At this time,
diverse training and experience are all that guide donor organ selection. Donor
variables are now recognized to influence patient and graft survival at 1 year
and beyond. Little is known about the molecular biology of hepatic ischemia/reperfusion
that might enable informed donor preparation and selection. This study of South-Eastern
Organ Procurement Foundation liver transplant centers identifies differences
among liver transplant surgeons in donor assessment as issues for further consideration.
Sixteen of 25 centers responded. A 170 mEq/L donor serum sodium was the upper
limit for acceptance. Selection based on donor vasopressor use lacked uniformity.
Preimplantation donor liver biopsy was used selectively, and the maximum acceptable
fat content was 30 per cent for most centers. Donor hospitalization for more
than 7 days was considered a negative factor by all groups. Surprisingly, five
centers were not using donor livers testing positive for hepatitis C. This study
points to the great variability in the assessment of organ donors. Greater consensus
in this area could lead to increased organ use and/or less retransplantation,
a net gain in organ economy.
PMID: 9697915, UI: 98361380
table Of Contents
|
