Timing of Organ Procurement From Brain-Dead Donors Associates With Short- and Long-Term Outcomes After Liver Transplantation
| Autor: | Eerola, Verner, Helanterä, Ilkka, Åberg, Fredrik, Lempinen, Marko, Mäkisalo, Heikki, Nordin, Arno, Isoniemi, Helena, Sallinen, Ville |
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| Přispěvatelé: | Clinicum, HUS Abdominal Center, IV kirurgian klinikka, Pertti Panula / Principal Investigator, Department of Anatomy, Helsinki University Hospital Area |
| Rok vydání: | 2022 |
| Předmět: |
organ allocation
liver allograft function Transplantation Tissue and Organ Procurement DURATION graft survival liver transplant dysfunction Brain donor hepatectomy 3126 Surgery anesthesiology intensive care radiology Severity of Illness Index Liver Transplantation TIME End Stage Liver Disease ACTIVATION procurement surgery SURVIVAL Humans brain death FAILURE |
| Zdroj: | Transplant International. 35 |
| ISSN: | 1432-2277 |
| DOI: | 10.3389/ti.2022.10364 |
| Popis: | Brain death-induced cytokine storm is thought to harm transplantable organs. However, longer procurement times have been associated with non-inferior or better outcomes in kidney, heart, and lung transplants, while optimal procurement time for liver allografts is unknown. Our aim was to analyze the association of time interval from brain death to organ procurement with liver allograft outcomes in two nationwide cohorts. The association of procurement interval with graft survival and short-term complications was analysed in multivariable models. Altogether 643 and 58,017 orthotopic liver transplantations from brain-dead donors were included from Finland between June 2004 and December 2017 and the US between January 2008 and August 2018, respectively. Median time from brain death to organ procurement was 10.5 h in Finland and 34.6 h in the US. Longer interval associated with better graft survival (non-linearly, p = 0.016) and less acute rejections (OR 0.935 95% CI 0.894–0.978) in the US cohort, and better early allograft function (p = 0.005; Beta −0.048 95% CI −0.085 −(−0.011)) in the Finnish cohort, in multivariable models adjusted with Donor Risk Index, recipient age, Model for End-Stage Liver Disease and indication for transplantation. Progressive liver injury after brain death is unlikely. Rushing to recover seems unnecessary; rest and repair might prove beneficial. |
| Databáze: | OpenAIRE |
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