Optimization of donor-recipient matching is a common concept in liver transplantation. In emergency transplant for acute liver failure, outcome is influenced by timing, patient clinical condition, and graft quality. Although factors like advanced donor age have been linked to a poorer outcome, use of suboptimal or marginal grafts can be inevitable in very unstable patients, if no other graft is available. We present a case of a liver transplant performed in an extremely sick patient suffering from HBV-related fulminant hepatitis, in which a compatible graft from a 76-year-old deceased donor became available only after 3 days of waiting time, during which his conditions further deteriorated. Given the suboptimal matching, normothermic machine perfusion was applied to minimize ischemia-reperfusion injury. Use of machine perfusion could find an indication to modulate the risk associated with an unfavorable donor-recipient matching in high-risk cases.

Shifting from donor to donor-recipient matching perspective in defining indications for machine perfusion in liver transplantation

Patrono D.;Lupo F.;Romagnoli R.
Last
2020-01-01

Abstract

Optimization of donor-recipient matching is a common concept in liver transplantation. In emergency transplant for acute liver failure, outcome is influenced by timing, patient clinical condition, and graft quality. Although factors like advanced donor age have been linked to a poorer outcome, use of suboptimal or marginal grafts can be inevitable in very unstable patients, if no other graft is available. We present a case of a liver transplant performed in an extremely sick patient suffering from HBV-related fulminant hepatitis, in which a compatible graft from a 76-year-old deceased donor became available only after 3 days of waiting time, during which his conditions further deteriorated. Given the suboptimal matching, normothermic machine perfusion was applied to minimize ischemia-reperfusion injury. Use of machine perfusion could find an indication to modulate the risk associated with an unfavorable donor-recipient matching in high-risk cases.
2020
72
3
913
915
Acute liver failure; Extended criteria donor; Normothermic machine perfusion; Adult; Hepatitis B; Humans; Liver; Male; Organ Preservation; Perfusion; Reperfusion Injury; Severity of Illness Index; Tissue and Organ Procurement; Graft Survival; Liver Transplantation; Tissue Donors
Patrono D.; Lupo F.; Romagnoli R.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/1770074
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