Liver Grafts with Major Extended Donor Criteria May Expand the Organ Pool for Patients with Hepatocellular Carcinoma

Autor: Jan Pfeiffenberger, Thomas Longerich, Elias Khajeh, Vladimir J Lozanovski, Karl Heinz Weiss, Markus Mieth, Markus W. Büchler, De-Hua Chang, Omid Ghamarnejad, Oliver Strobel, Arianeb Mehrabi, Katrin Hoffmann, Larissa T B Kerr
Rok vydání: 2019
Předmět:
Zdroj: Journal of Clinical Medicine
Volume 8
Issue 10
Journal of Clinical Medicine, Vol 8, Iss 10, p 1692 (2019)
ISSN: 2077-0383
Popis: The major extended donor criteria (maEDC
steatosis >
40%, age >
65 years, and cold ischemia time >
14 h) influence graft and patient outcomes after liver transplantation. Despite organ shortages, maEDC organs are often considered unsuitable for transplantation. We investigated the outcomes of maEDC organ liver transplantation in patients with hepatocellular carcinoma (HCC). Two hundred and sixty-four HCC liver transplant patients were eligible for analysis. Risk factor analysis was performed for early allograft dysfunction
primary nonfunction
30-day and 90-day graft failure
and 30-day, 90-day, and 1-year patient mortality. One-year graft survival was higher in recipients of no-maEDC grafts. One-year patient survival did not differ between the recipients of no-maEDC and maEDC organs. The univariate and multivariate analyses revealed no association between maEDC grafts and one-year patient mortality. Graft survival differed between the recipients of no-maEDC and maEDC organs after correcting for a laboratory model of end-stage liver disease (labMELD) score with a cut-off value of 20, but patient survival did not. Patient survival did not differ between recipients who did and did not meet the Milan criteria and who received grafts with and without maEDC. Instead of being discarded, maEDC grafts may expand the organ pool for patients with HCC without impairing patient survival or recurrence-free survival.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje