Liver transplantation choice of donor: Difference between revisions

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* A predictive model comprised of donor factors known at the time an organ is offered to quantify the risk of graft failure, and this model is known as the donor risk index.<ref name="pmid16539636">{{cite journal| author=Feng S, Goodrich NP, Bragg-Gresham JL, Dykstra DM, Punch JD, DebRoy MA et al.| title=Characteristics associated with liver graft failure: the concept of a donor risk index. | journal=Am J Transplant | year= 2006 | volume= 6 | issue= 4 | pages= 783-90 | pmid=16539636 | doi=10.1111/j.1600-6143.2006.01242.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16539636  }}</ref>  
* A predictive model comprised of donor factors known at the time an organ is offered to quantify the risk of graft failure, and this model is known as the donor risk index.<ref name="pmid16539636">{{cite journal| author=Feng S, Goodrich NP, Bragg-Gresham JL, Dykstra DM, Punch JD, DebRoy MA et al.| title=Characteristics associated with liver graft failure: the concept of a donor risk index. | journal=Am J Transplant | year= 2006 | volume= 6 | issue= 4 | pages= 783-90 | pmid=16539636 | doi=10.1111/j.1600-6143.2006.01242.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16539636  }}</ref>  
* The parameters most strongly associated with graft loss include increasing donor age, donation after cardiac death, and use of split/partial grafts.  
* The parameters most strongly associated with graft loss include increasing donor age, donation after cardiac death, and use of split/partial grafts.  
* Other risk factors include African American donors, shorter donors, death due to a cerebrovascular accident, and causes of brain death other than trauma or anoxia.
* Death due to a cerebrovascular accident
* Causes of brain death other than trauma or anoxia
'''Hepatitis C-positive donors'''
'''Hepatitis C-positive donors'''
* Transplantation of livers from hepatitis C virus-positive donors into HCV+ recipients initially may cause recurrent liver disease due to  introduction of new viral strains into the recipient.<ref name="pmid27456927">{{cite journal| author=Bowring MG, Kucirka LM, Massie AB, Luo X, Cameron A, Sulkowski M et al.| title=Changes in Utilization and Discard of Hepatitis C-Infected Donor Livers in the Recent Era. | journal=Am J Transplant | year= 2017 | volume= 17 | issue= 2 | pages= 519-527 | pmid=27456927 | doi=10.1111/ajt.13976 | pmc=5266634 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27456927  }}</ref>
* Transplantation of livers from hepatitis C virus-positive donors into HCV+ recipients initially may cause recurrent liver disease due to  introduction of new viral strains into the recipient.<ref name="pmid27456927">{{cite journal| author=Bowring MG, Kucirka LM, Massie AB, Luo X, Cameron A, Sulkowski M et al.| title=Changes in Utilization and Discard of Hepatitis C-Infected Donor Livers in the Recent Era. | journal=Am J Transplant | year= 2017 | volume= 17 | issue= 2 | pages= 519-527 | pmid=27456927 | doi=10.1111/ajt.13976 | pmc=5266634 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27456927  }}</ref>

Revision as of 22:05, 27 December 2017


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

Liver trasnsplantation Microchapters

Home

Patient Information

Overview

Historical Perspective

Indications

Pre-surgical management

Choice of donor

Epidemiology and Demographics

Techniques

Complications

Acute rejection

Immune therapy

Post-surgical infection

Prognosis

Overview

Liver transplantation choice of donor

Donation after brain death

Laboratory testing for donors includes:[1]

Donor risk index

  • A predictive model comprised of donor factors known at the time an organ is offered to quantify the risk of graft failure, and this model is known as the donor risk index.[3]
  • The parameters most strongly associated with graft loss include increasing donor age, donation after cardiac death, and use of split/partial grafts.
  • Death due to a cerebrovascular accident
  • Causes of brain death other than trauma or anoxia

Hepatitis C-positive donors

  • Transplantation of livers from hepatitis C virus-positive donors into HCV+ recipients initially may cause recurrent liver disease due to introduction of new viral strains into the recipient.[4]

Hepatitis B-positive donors

  • Liver transplantation from donors with serologic markers for HBV infection has the potential to increase the donor pool.[5]
  • It is generally recommended that grafts from hepatitis B core antibody positive donors should be offered to hepatitis B surface antigen positive recipients.
  • Recipients who lack HBV markers may also be eligible provided that they receive effective HBV prophylaxis post-transplantation.
  • The use of hepatitis B immunoglobulin or an oral antiviral agent reduces the risk of HBV infection in HBsAg-negative patients who receive an HBcAb-positive liver. [66-69]. 

References

  1. ↑ Kucirka LM, Alexander C, Namuyinga R, Hanrahan C, Montgomery RA, Segev DL (2009). "Viral nucleic acid testing (NAT) and OPO-level disposition of high-risk donor organs". Am J Transplant. 9 (3): 620–8. doi:10.1111/j.1600-6143.2008.02522.x. PMID 19191766.
  2. ↑ Kluger MD, Guarrera JV, Olsen SK, Brown RS, Emond JC, Cherqui D (2012). "Safety of blood group A2-to-O liver transplantation: an analysis of the United Network of Organ Sharing database". Transplantation. 94 (5): 526–31. doi:10.1097/TP.0b013e31825c591e. PMID 22874840.
  3. ↑ Feng S, Goodrich NP, Bragg-Gresham JL, Dykstra DM, Punch JD, DebRoy MA; et al. (2006). "Characteristics associated with liver graft failure: the concept of a donor risk index". Am J Transplant. 6 (4): 783–90. doi:10.1111/j.1600-6143.2006.01242.x. PMID 16539636.
  4. ↑ Bowring MG, Kucirka LM, Massie AB, Luo X, Cameron A, Sulkowski M; et al. (2017). "Changes in Utilization and Discard of Hepatitis C-Infected Donor Livers in the Recent Era". Am J Transplant. 17 (2): 519–527. doi:10.1111/ajt.13976. PMC 5266634. PMID 27456927.
  5. ↑ Marroquin CE, Marino G, Kuo PC, Plotkin JS, Rustgi VK, Lu AD; et al. (2001). "Transplantation of hepatitis C-positive livers in hepatitis C-positive patients is equivalent to transplanting hepatitis C-negative livers". Liver Transpl. 7 (9): 762–8. doi:10.1053/jlts.2001.27088. PMID 11552208.
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