The marginal donor: a single-center experience in orthotopic liver transplantation

Olival Cirilo Lucena da Fonseca-Neto Luiz Eduardo Correia Miranda Bernardo David Sabat Américo Gusmão Amorim Luiz Adeodato Paulo Sérgio Vieira de Melo Helry Cândido Lopes Cláudio Moura Lacerda Leila Maria Moreira Beltrão Pereira About the authors

BACKGROUND: Since marginal grafts are a solution to deal with the shortage of organ donors, its use became more common worldwide, and the literature had shown its effectiveness in the liver transplantation (LT) outcomes. AIM: To present a single center experience, at the Liver Transplantation Unit of Oswaldo Cruz University Hospital, with orthotopic LT using marginal organ donors. METHODS: Retrospectivety review of 137 orthotopic LT using marginal grafts between 1999 and 2006, with a minimum 180 days follow-up. The receptors were classified according to postoperative initial graft function as normal function (NF) and primary dysfunction (PD). RESULTS: No significant statistic difference was observed between groups NF and PD concerning the following donor's parameters: donor's age, serum sodium, prothrombine time, liver steatosis, serum transaminasis, blood pressure, vasoactive drugs, body mass index, heart attack prior organ donation, non-heart-beating donor and warm ischemia time. The survival curves' analysis (Kaplan-Meier) of patients or patients' grafts which received LT from ideal donors versus marginal donors showed no significant difference. CONCLUSIONS: The results permit to recommend the use of liver marginal grafts, including that ones from non-heart-beating donors.

Liver transplantation; Directed tissue donation; Liver cirrhosis; Immunosuppression

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