Liver transplantation choice of donor

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

Overview

in 2013, a law was passed that ended a ban on transplanting organs from donors with HIV into HIV-positive recipients because of better HIV therapy as well as high waiting list mortality rates for patients with HIV [1]
Laboratory testing generally includes:
ABO blood type
complete blood count (CBC)
chemistries
prothrombin time (PT)
activated partial thromboplastin time (PTT)
hepatitis B surface antigen (HBsAg)
anti-hepatitis B core antigen (HBc)
anti-hepatitis C virus (HCV)
anti-HIV
venereal disease research laboratory (VDRL)
rapid plasma reagin (RPR)
anti-cytomegalovirus (CMV)
nucleic acid testing (NAT) for HIV and HCV in all or selected high risk donors [3]

Livers are routinely matched by ABO blood type (ABO identical), although mismatched organs have been used in extreme circumstances. Mismatched organs may either be ABO compatible (eg, an organ from a donor who is type O going to a recipient who is type B) or ABO incompatible (eg, an organ from an donor who is type A going to a recipient who is type B).
two-year graft survival was 30 percent in 17 ABO-incompatible emergency transplants compared with 76 percent in 55 ABO-compatible emergency transplants and 80 percent in 162 ABO-compatible elective transplants [42] [43].
good outcomes have been reported among recipients with blood type O who receive an organ from a donor with blood type A2 with overall and graft survival rates that are similar to those seen when a recipient with blood type O receives an ABO-compatible organ [44].