Marginal donors in liver transplantation
| Autor: | Luca Toti, N. De Liguori Carino, Giuseppe Tisone, S Zazza, I De Luca, C Ciceroni, Tommaso Maria Manzia, Cu Casciani |
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| Rok vydání: | 2004 |
| Předmět: |
medicine.medical_specialty
Bilirubin medicine.medical_treatment Liver transplantation Liver transplants Gastroenterology Donor age law.invention Sepsis chemistry.chemical_compound law Internal medicine medicine Humans Obesity Retrospective Studies Transplantation business.industry Patient Selection Age Factors Middle Aged medicine.disease Macrovesicular steatosis Survival Analysis Intensive care unit Tissue Donors Liver Transplantation Surgery Settore MED/18 - Chirurgia Generale chemistry Liver donors business Follow-Up Studies |
| Zdroj: | Transplantation Proceedings. 36:525-526 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2004.02.022 |
| Popis: | Marginal liver donor criteria included the following: obesity (weight100 Kg or BMI27), age50 years; macrovesicular steatosis50%; intensive care unit stay4 days; prolonged hypotensive episodes of1 hour, and60 mm Hg with high inotropic drug use (dopamine, [DPM]14 microg/kg per minute); cold ischemia time14 hours, peak serum sodium155 mEq/L; sepsis, viral infections, and alcoholism; high levels of bilirubin, ALT, and AST, or extrahepatic neoplasia. Between August 1992 and May 2003, we performed 251 liver transplants in 241 patients of whom 155 are presently alive. We used 124 (49.4%) standard donors and 127 (50.6%) marginal donors. Among the group that received a standard donor, 81 (65.3%) are still alive. Among recipients of organs from marginal donors. 81 (63.8%) are still alive. We also assessed the quality of donors according to the severity of recipient disease. For standard donors these outcomes were 61.5% for UNOS 1, 37.5% for UNOS 2A, 73.2% for UNOS 2B, and 80% for UNOS 3 for marginal donors they were 46.1% for UNOS 1, 53.6% for UNOS 2A, 70.7% for UNOS 2B, and 63.6% for UNOS 3. Among the patients who received a liver from a donor60 years old, there were no survivors in UNOS 1 and 2A, but there were good results in groups 2B and 3. These results suggest there is no difference between marginal and standard donors, even in sick patients, with the exception of donor age. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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