Non Beating Heart Donors as a Possible Source for Liver Transplantation

Jc, García-Valdecasas

doi:10.1080/00015458.2000.12098564

Cited by 19 publications

(2 citation statements)

References 27 publications

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“…[1][2][3] For patients with these diseases, liver transplantation is the single most effective approach to improve patient survival. However, a lack of donor livers hinders liver transplantation, [4][5][6][7] but over the past two decades, the number of donors has increased because of extended donor criteria. 6,8 Nevertheless, macrovesicular hepatic steatosis (MHS) may impair liver function and is recognized as the mostsignificant prognostic histologic parameter in predicting post-transplant graft loss.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of hepatic steatosis before liver transplantation in ex vivo by volumetric quantitative PDFF‐MRI

Chen

Jiang

Wang

et al. 2020

Magnetic Resonance in Med

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Purpose Over the last two decades, extended criteria have promoted an increased number of donor livers available for liver transplantation. But posttransplant graft loss is still a major concern. Macrovesicular hepatic steatosis (MHS) is recognized as the most significant prognostic histologic parameter in predicting posttransplant graft loss. We aimed to evaluate the utility of ex vivo volumetric quantitative MRI for quantifying MHS before liver transplantation using proton density fat‐fraction (PDFF‐MRI) histogram analysis. Methods PDFF‐MRI was performed at 3.0T in 40 livers. We obtained histogram parameters of whole‐liver volume of interest, including the mean, median, 5th, 10th, 25th, 75th, 90th, and 95th percentile PDFF; skewness; kurtosis; entropy; and volume. Results Livers from 40 cadaveric donors were included, and histologic ex vivo fat quantification was available for 33 livers. Ten livers had MHS and 23 had normal fat content. The MHS group had higher mean, median, 5th, 10th, 25th, 75th, 90th, and 95th percentile PDFF, and entropy than the group with normal fat content (P < .05). Median PDFF had greater area under the curve value than other parameters. Mean PDFF showed an excellent correlation with entropy and a moderate correlation with MHS quantification on histology. Conclusions Ex vivo volumetric quantitative PDFF‐MRI histogram analysis is a very useful and noninvasive method to detect MHS before liver transplantation. Median PDFF was the best predictor of the presence of MHS. Entropy is a very promising parameter.

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Section: Introductionmentioning

confidence: 99%

Evaluation of hepatic steatosis before liver transplantation in ex vivo by volumetric quantitative PDFF‐MRI

Chen

Jiang

Wang

et al. 2020

Magnetic Resonance in Med

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“…These factors have, in turn, significantly lengthened waiting lists (11), with an average patient stay of approximately 1.5-2 y accompanied by a mortality rate of 6-7%. Thus, increasing availability of organs is necessary and urgent in order to cope with increasing demand for marginal livers (12). Donation after circulatory determination of death (DCDD) and steatotic livers are considered unreliable for transplantation with current conservation techniques, as their applicability necessitates preservation of the features that are partially impaired by steatosis or the initial period of warm ischemia.…”

Section: Introductionmentioning

confidence: 99%

Perfusion machines for liver transplantation: technology and multifunctionality

Rubbini

2013

Updates Surg

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The reliability of machine perfusion (alternative to static cold storage) for the preservation of liver for transplantation has been well investigated in experimental models, by taking into account the temperature, oxygenation, flow, pressure, and settings of the machine or proposed circuit. Machine perfusion is considered by many researchers as a valid method for preserving organs. While circuits or machines for preservation have been described, no agreement has been reached concerning how these devices should be developed. The machines proposed to date are considered here to identify the technical and functional features necessary for a machine to have multifunctionality and adaptability to cater all the needs of preservation, according to the type and features of the liver to be transplanted, including marginal livers. The need to establish a uniform method for the use of this machine is also emphasized, to achieve a clinical protocol for its use.

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Similar liver transplantation survival with selected cardiac death donors and brain death donors

Dubbeld

Hoekstra

Farid

et al. 2010

British Journal of Surgery

187

140

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Background:The outcome of orthotopic liver transplantation (OLT) with controlled graft donation after cardiac death (DCD) is usually inferior to that with graft donation after brain death (DBD). This study compared outcomes from OLT with DBD versus controlled DCD donors with predefined restrictive acceptance criteria. Results: One-and 3-year patient survival rates were similar for DCD (85 and 80 per cent) and DBD (86·3 and 80·8 per cent) transplants (P = 0·763), as were graft survival rates (74 and 68 per cent versus 80·4 and 74·5 per cent; P = 0·212). The 3-year cumulative percentage of surviving grafts developing non-anastomotic biliary strictures was 31 per cent after DCD and 9·7 per cent after DBD transplantation (P < 0·001). The retransplantation rate was similar overall (P = 0·081), but that for biliary stricture was higher in the DCD group (P < 0·001). Risk factors for 1-year graft loss after DBD OLT were transplant centre, recipient warm ischaemia time and donor with severe head trauma. After DCD OLT they were transplant centre, donor warm ischaemia time and cold ischaemia time. DCD graft was a risk factor for non-anastomotic biliary stricture.Conclusion: OLT using controlled DCD grafts and restrictive criteria can result in patient and graft survival rates similar to those of DBD OLT, despite a higher risk of biliary stricture.

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Non Beating Heart Donors as a Possible Source for Liver Transplantation

Cited by 19 publications

References 27 publications

Evaluation of hepatic steatosis before liver transplantation in ex vivo by volumetric quantitative PDFF‐MRI

Evaluation of hepatic steatosis before liver transplantation in ex vivo by volumetric quantitative PDFF‐MRI

Perfusion machines for liver transplantation: technology and multifunctionality

Similar liver transplantation survival with selected cardiac death donors and brain death donors

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