Recipient Selection for Optimal Utilization of Discarded Grafts in Liver Transplantation

Giretti, Giovanni; Barbier, Louise; Bucur, Petru; Marques, F.; Perarnau, Jean–Marc; Ferrandière, Martine; Tellier, Anne-Charlotte; Kerouredan, V; Altieri, Mario; Causse, Xavier; Debette‐Gratien, Maryline; Silvain, Christine; Salamé, Ephrem

doi:10.1097/tp.0000000000002069

Cited by 20 publications

(46 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Indeed, in Eurotransplant, more than 20% of LTs are considered as CA, whereas in France this subpopulation only accounts for 6% of LTs. Giretti et al 8 conducted a single centre study in France that involved 354 LTs, only 33 of which were CA transplants. Patient survival did not differ between CA and PA grafts.…”

Section: Discussionmentioning

confidence: 99%

“…Giretti et al. 8 conducted a single centre study in France that involved 354 LTs, only 33 of which were CA transplants. Patient survival did not differ between CA and PA grafts.…”

Section: Discussionmentioning

confidence: 99%

“…Five series with a restrictive number of patients relative to this CA strategy have been reported. [5][6][7][8][9] In the face of liver shortages, our aim was to determine whether the survival of CA recipients/grafts was worse than that of PA recipients/grafts, taking account of selection bias. Furthermore, we explored the survival benefit offered by CA grafts by comparing grafting a patient with a CA graft without delay rather than remaining on the waiting list and possibly receiving a PA graft at a later point.…”

Section: Should We Use Liver Grafts Repeatedly Refused By Other Transmentioning

confidence: 99%

“…Five series with a restrictive number of patients relative to this CA strategy have been reported. [5] , [6] , [7] , [8] , [9] …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Should we use liver grafts repeatedly refused by other transplant teams?

et al. 2020

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…Giretti et al. 8 conducted a single centre study in France that involved 354 LTs, only 33 of which were CA transplants. Patient survival did not differ between CA and PA grafts.…”

Section: Discussionmentioning

confidence: 99%

Section: Should We Use Liver Grafts Repeatedly Refused By Other Transmentioning

confidence: 99%

“…Five series with a restrictive number of patients relative to this CA strategy have been reported. [5] , [6] , [7] , [8] , [9] …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Should we use liver grafts repeatedly refused by other transplant teams?

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In this review, we define marginal liver grafts for LDLT as small-for-size grafts, older donors, moderate or severe steatosis of liver grafts, chronic hepatitis, and grafts with tumors. The survival of recipients with marginal organs can be the same as that of patients with high-quality liver grafts under proper treatment[ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of using marginal liver grafts in living donor liver transplantation

Xiang

Zhang

et al. 2018

WJG

View full text Add to dashboard Cite

Liver transplantation (LT) is one of the most effective treatments for end-stage liver disease caused by related risk factors when liver resection is contraindicated. Additionally, despite the decrease in the prevalence of hepatitis B virus (HBV) over the past two decades, the absolute number of HBsAg-positive people has increased, leading to an increase in HBV-related liver cirrhosis and hepatocellular carcinoma. Consequently, a large demand exists for LT. While the wait time for patients on the donor list is, to some degree, shorter due to the development of living donor liver transplantation (LDLT), there is still a shortage of liver grafts. Furthermore, recipients often suffer from emergent conditions, such as liver dysfunction or even hepatic encephalopathy, which can lead to a limited choice in grafts. To expand the pool of available liver grafts, one option is the use of organs that were previously considered “unusable” by many, which are often labeled “marginal” organs. Many previous studies have reported on the possibilities of using marginal grafts in orthotopic LT; however, there is still a lack of discussion on this topic, especially regarding the feasibility of using marginal grafts in LDLT. Therefore, the present review aimed to summarize the feasibility of using marginal liver grafts for LDLT and discuss the possibility of expanding the application of these grafts.

show abstract

Indocyanine Green Fluorescence Imaging to Predict Graft Survival After Orthotopic Liver Transplantation: A Pilot Study

et al. 2020

View full text Add to dashboard Cite

The incidence of primary nonfunction (PNF) after liver transplantation (LT) remains a major concern with the increasing use of marginal grafts. Indocyanine green (ICG) fluorescence is an imaging technique used in hepatobiliary surgery and LT. Because few early predictors are available, we aimed to quantify in real time the fluorescence of grafts during LT to predict 3‐month survival. After graft revascularization, ICG was intravenously injected, and then the fluorescence of the graft was captured with a near infrared camera and postoperatively quantified. A multiparametric modeling of the parenchymal fluorescence intensity (FI) curve was proposed, and a predictive model of graft survival was tested. Between July 2017 and May 2019, 76 LTs were performed, among which 6 recipients underwent retransplantation. No adverse effects of ICG injection were observed. The parameter a150 (temporal course of FI) was significantly higher in the re‐LT group (0.022 seconds−1 (0.0011‐0.059) versus 0.012 seconds−1 (0.0001‐0.054); P = 0.01). This parameter was the only independent predictive factor of graft survival at 3 months (OR, 2.4; 95% CI, 1.05‐5.50; P = 0.04). The best cutoff for the parameter a150 (0.0155 seconds−1) predicted the graft survival at 3 months with a sensitivity (Se) of 83.3% and a specificity (Spe) of 78.6% (area under the curve, 0.82; 95% CI, 0.67‐0.98; P = 0.01). Quantitative assessment of intraoperative ICG fluorescence on the graft was feasible to predict graft survival at 3 months with a good Se and Spe. Further prospective studies should be undertaken to validate these results over larger cohorts and evaluate the clinical impact of this tool.

show abstract

Recipient Selection for Optimal Utilization of Discarded Grafts in Liver Transplantation

Cited by 20 publications

References 28 publications

Should we use liver grafts repeatedly refused by other transplant teams?

Should we use liver grafts repeatedly refused by other transplant teams?

Feasibility of using marginal liver grafts in living donor liver transplantation

Indocyanine Green Fluorescence Imaging to Predict Graft Survival After Orthotopic Liver Transplantation: A Pilot Study

Contact Info

Product

Resources

About