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Rescue policy for discarded liver grafts: a single-centre experience of transplanting livers 'that nobody wants'.
- Source :
-
HPB . Oct2010, Vol. 12 Issue 7, p523-530. 8p. - Publication Year :
- 2010
-
Abstract
- Background: There is a worldwide need to expand the donor liver pool. We report a consecutive series of elective candidates for liver transplantation (LT) who received 'livers that nobody wants' (LNWs) in Argentina. Methods: Between 2006 and 2009, outcomes for patients who received LNWs were analysed and compared with outcomes for a control group. To be defined as an LNW, an organ is required to fulfill two criteria. Firstly, each liver must be officially offered and refused more than 30 times; secondly, the liver must be refused by at least 50% of the LT programmes in our country before our programme can accept it. Principal endpoints were primary graft non-function (PNF), mortality, and graft and patient survival. Results: We transplanted 26 LNWs that had been discarded by a median of 12 centres. A total of 2666 reasons for refusal had been registered. These included poor donor status (n = 1980), followed by LT centre (n = 398) or recipient (n = 288) conditions. Incidences of PNF (3.8% vs. 4.0%), in-hospital mortality (3.8% vs. 8.0%), 1-year patient (84% vs. 84%) and graft (84% vs. 80%) survival were equal in the LNW and control groups. Conclusions: Transplantable livers are unnecessarily discarded by the transplant community. External and internal supervision of the activity of each LT programme is urgently needed to guarantee high standards of excellence. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 1365182X
- Volume :
- 12
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- HPB
- Publication Type :
- Academic Journal
- Accession number :
- 91680568
- Full Text :
- https://doi.org/10.1111/j.1477-2574.2010.00193.x