Marginal donors for patients on regular waiting lists for liver transplantation

  • S. Agnes
  • A. W. Avolio
  • S. C. Magalini
  • G. Grieco
  • M. Castagneto
Conference paper

Abstract

The use of marginal donors is well accepted by most centers for emergency situations, but there is debate on their use for patients on regular waiting lists. We report our experience of the 1-year survival for patients on waiting lists (n = 147, 1-year survival = 32%), patients transplanted from good donors (n = 60, 1-year survival = 84%), and patients transplanted from marginal donors (n = 15, 1-year survival = 56%). We concluded that liver transplantation from marginal donors (a) is a safe procedure (b) has a 1-year survival that is significantly better than that on a waiting list (c) is ethically justified especially in countries with donor shortages, and (d) may allow transplantation of “special” high risk and poor longterm outcome patients.

Keywords

Liver waiting list Marginal donor Donor shortage Donor selection criteria Liver transplantation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Annual Report of the US Scien- 4. tific Registry of Transplant Recipients and the Organ Procurement and Transplantation Network (1993) Transplant data 1988–91. Appendix H: Deaths on 5. the waiting list. H2Google Scholar
  2. 2.
    Roels L, Vabrenterghem Y, Waer M, et al (1990) The aging kidney donor: 6. another answer to organ shortage? Transplant Proc 22: 368PubMedGoogle Scholar
  3. 3.
    Pettersen G, Berglin E, Berggren WO, et al (1990) Are older donors accept- 7. able for heart transplantation? Transplant Proc 22: 247Google Scholar
  4. 4.
    Alexander JW, Vaughn WK (1991) The use of marginal donors for organ transplantation: the influence of donor age on outcome. Transplantation 51: 135PubMedCrossRefGoogle Scholar
  5. 5.
    Mirza DF, Gunson BK, Da Silva R, et al (1994) Policies in Europe on “marginal quality” donor livers. Lancet 344: 1480PubMedCrossRefGoogle Scholar
  6. 6.
    Pruim H, Klompmaker IJ, Haagsma EB, et al (1993) Selection criteria for liver donation: a review. Transplant Int 6: 226–35CrossRefGoogle Scholar
  7. 7.
    Temperman L, Podesta L, Mieles L, et al (1989) The successful use of older donors for liver transplantation. JAMA 262: 2837CrossRefGoogle Scholar
  8. 8.
    Mor E, Klintman GB, Gonwa TA, et al (1992) The use of marginal donors for liver transplantation: a retrospective study of 365 liver donors. Transplantation 53: 383–386PubMedCrossRefGoogle Scholar
  9. 9.
    Avolio AW, Agnes S, Magalini SC, Nanni G, Castagneto M (1992) “Recovery index” a useful tool for quantification of liver injury after liver transplantation and prediction of one year survival. Transplant Proc 24: 2707–2708Google Scholar
  10. 10.
    Avolio AW, Agnes S, Magalini SC, Nanni G, Castagneto M (1993) Quantification of liver damage and prediction of one-year survival after liver transplantation by a multifactorial “recovery score”. Transplant Proc 25: 1868–1869PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • S. Agnes
    • 1
  • A. W. Avolio
    • 1
  • S. C. Magalini
    • 1
  • G. Grieco
    • 1
  • M. Castagneto
    • 1
  1. 1.Department of Surgery — Division of Organ TransplantationCatholic UniversityRomeItaly

Personalised recommendations