Long-term results after liver transplantation with "livers that nobody wants" within Eurotransplant

TY - JOUR

T1 - Long-term results after liver transplantation with "livers that nobody wants" within Eurotransplant

T2 - a center's experience

AU - Sotiropoulos, G C

AU - Lang, H

AU - Saner, F H

AU - Beckebaum, S

AU - Wandelt, M

AU - Molmenti, E P

AU - Nadalin, S

AU - Treckmann, J

AU - Bockhorn, M

AU - Fouzas, I

AU - Malagó, M

AU - Gerken, G

AU - Broelsch, C E

AU - Paul, A

PY - 2008/11/1

Y1 - 2008/11/1

N2 - BACKGROUND: Orthotopic liver transplantation (OLT) represents the only curative treatment for end-stage liver disease, but its application is limited because of organ shortages. The purpose of this study was to review the long-term outcomes after OLT during a 2-year period of 45 rescue offers organs within Eurotransplant.PATIENTS AND METHODS: Forty-five deceased donor liver allografts had been officially offered to and rejected by other transplantation centers 162 times prior to our acceptance. Data analysis addressed recurrence of primary disease, ischemic-type biliary lesions (ITBL), re-evaluation or relisting for OLT, re-OLT, as well as overall patient and graft survivals.RESULTS: Six patients underwent retransplantation because of primary nonfunction (n = 4), hepatitis C recurrence (n = 1), and secondary biliary cirrhosis following ITBL (n = 1). Five additional patients developed ITBL and received endoscopic treatment. Currently, 34 patients are alive after a median follow-up of 44.5 months. Median graft survival is 43.2 months. Patient versus patient/first graft survival at 1, 3, and 5 years is 82%, 78%, and 74%, versus 76%, 69%, and 65%, respectively.CONCLUSIONS: OLT with rescue organs is a reasonable policy, with acceptable long-term patient/graft survivals, providing a real expansion of the donor pool.

AB - BACKGROUND: Orthotopic liver transplantation (OLT) represents the only curative treatment for end-stage liver disease, but its application is limited because of organ shortages. The purpose of this study was to review the long-term outcomes after OLT during a 2-year period of 45 rescue offers organs within Eurotransplant.PATIENTS AND METHODS: Forty-five deceased donor liver allografts had been officially offered to and rejected by other transplantation centers 162 times prior to our acceptance. Data analysis addressed recurrence of primary disease, ischemic-type biliary lesions (ITBL), re-evaluation or relisting for OLT, re-OLT, as well as overall patient and graft survivals.RESULTS: Six patients underwent retransplantation because of primary nonfunction (n = 4), hepatitis C recurrence (n = 1), and secondary biliary cirrhosis following ITBL (n = 1). Five additional patients developed ITBL and received endoscopic treatment. Currently, 34 patients are alive after a median follow-up of 44.5 months. Median graft survival is 43.2 months. Patient versus patient/first graft survival at 1, 3, and 5 years is 82%, 78%, and 74%, versus 76%, 69%, and 65%, respectively.CONCLUSIONS: OLT with rescue organs is a reasonable policy, with acceptable long-term patient/graft survivals, providing a real expansion of the donor pool.

KW - Adult

KW - Cadaver

KW - Female

KW - Graft Survival

KW - Humans

KW - Liver Failure

KW - Liver Transplantation

KW - Male

KW - Middle Aged

KW - Patient Selection

KW - Reoperation

KW - Survival Rate

KW - Survivors

KW - Tissue Donors

KW - Transplantation, Homologous

KW - Treatment Outcome

U2 - 10.1016/j.transproceed.2008.08.055

DO - 10.1016/j.transproceed.2008.08.055

M3 - SCORING: Journal article

C2 - 19010232

VL - 40

SP - 3196

EP - 3197

JO - TRANSPL P

JF - TRANSPL P

SN - 0041-1345

IS - 9

ER -