Effect of airplane transport of donor livers on post-liver transplantation survival

Huang, Yi Hsiang; MacQuillan, Gerry; Adams, Leon A.; Garas, George; Collins, Megan; Nwaba, Albert; Mou, Linjun; Bulsara, Max; Delrivière, Luc; Jeffrey, Gary P.

doi:10.3748/wjg.v22.i41.9154

Cited by 7 publications

(6 citation statements)

References 11 publications

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“…Based on United Network for Organ Sharing (UNOS) database, longer CIT was significantly associated with increased risk for post-transplant prolonged length of stay [34], indicating that modes of transportation in larger geographical areas may affect graft survival. When compared to local donor livers, airplane transported livers showed worse graft survival and patient survival [35].…”

Section: Notes Symbolmentioning

confidence: 89%

Asian Pacific Association for the Study of the Liver clinical practice guidelines on liver transplantation

Kim,

Yoon,

Kim

et al. 2024

Hepatol Int

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Liver transplantation is a highly complex and challenging field of clinical practice. Although it was originally developed in western countries, it has been further advanced in Asian countries through the use of living donor liver transplantation. This method of transplantation is the only available option in many countries in the Asia-Pacific region due to the lack of deceased organ donation. As a result of this clinical situation, there is a growing need for guidelines that are specific to the Asia-Pacific region. These guidelines provide comprehensive recommendations for evidence-based management throughout the entire process of liver transplantation, covering both deceased and living donor liver transplantation. In addition, the development of these guidelines has been a collaborative effort between medical professionals from various countries in the region. This has allowed for the inclusion of diverse perspectives and experiences, leading to a more comprehensive and effective set of guidelines. Keywords Living donor liver transplantation • Deceased donor liver transplantation • Multidisciplinary • GradeSpecial consideration: LDLT in ACLF In a study of 112 LDLT recipients with ACLF, defined by the APASL definition, post-LT outcomes were excellent (92.9% at 5 years) [69]. In a study on high-model end-stage liver disease (MELD) (score ≥ 30) LDLT recipients with ACLF (n = 190), defined by the World Congress of Gastroenterology [70], the 5-year survival rate was 72.1% [71]. In a study of 117 LDLT recipients who had ACLF, as defined by the EASL-CLIF definition, post-transplant survival after LDLT was 92.9%, 85.4%, and 75.6% at 1 year, while mortality rate without LT was 28.5%, 77.7%, and 93.4% at 90 days, for ACLF grades 1, 2, and 3, respectively [72]. These data indicate that LDLT can be a life-saving treatment option for patients with ACLF.LDLT differs significantly from DDLT, as the timing of LDLT can be determined by the transplant team. There are advantages and disadvantages of LDLT in the setting of ACLF. The benefit of LDLT in patients with ACLF is its ability to provide rapid transplantation to critically ill patients [73], without waiting for deceased donor allocation. The ideal time for LT can be selected by transplant team when willing living donor is available. If ideal time for LT can be selected in the dynamic course of ACLF, this may improve post-LT outcome. The disadvantages of LDLT include the need for healthy, willing liver donor, and the use of partial grafts for critically ill patients. A graft-to-recipient weight ratio (GRWR) is a factor associated with post-LT outcomes in LDLT [74]. The donor risk index is a factor associated with post-LT outcomes for patients with ACLF who received DDLT [66,75]. This indicates that DDLT, which uses whole liver grafts, might be a better compared to LDLT, which uses partial grafts, in ACLF. In addition, there are uncertainties regarding the criteria for living donor graft quality that is required for critically ill patients with ACLF. In studies that reported...

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Section: Notes Symbolmentioning

confidence: 89%

Asian Pacific Association for the Study of the Liver clinical practice guidelines on liver transplantation

Kim,

Yoon,

Kim

et al. 2024

Hepatol Int

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“…Supporting this notion, Gámez Córdoba et al have reported that graft transportation in uences primary dysfunction and graft survival [6]. Huang et al also demonstrated that airplane transport of grafted livers can reduce graft survival following liver transplantation [11]. However, the in uence of donor transportation on the outcome of deceased organ donation remains to be elucidated.…”

Section: Discussionmentioning

confidence: 99%

“…Although previous studies have reported the relationship between long-distance transportation of grafted organ and graft outcome [6][7][8][9][10][11], nevertheless, the impact of donor transportation on the outcome of deceased organ donation remains largely unknown. Therefore, the purpose of this study was to investigate the effect of donor transportation on the function of the donor's organs.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Donor Transportation on the Function of Donor’s Organs

Liu

Wang

et al. 2021

Preprint

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Background: The impact of donor transportation on the outcome of deceased organ donation remains largely unknown. This study aimed to investigate the effect of donor transportation on the function of the donor’s organs. Methods: From 2016 to 2018, 139 donors of successful deceased organ donation from the local (primary) hospitals transferred to our hospital were included for analysis. Blood samples were drawn immediately after the donor admitted to our hospital (pre-transport data) and before donation (post-transport data) to assess the donor’s organ functions by determining the levels of blood biochemical indexes. Results: The donor with a transport distance >200 km had higher post-transportation AST and a bigger change of TB level as compared with those with a transport distance < 200 km. Pearson’s correlation analysis showed a positive correlation between transport distance and post-transport AST. The donors with cardiac arrest history had significantly higher pre-transport AST, pre-transport ALT, post-transport ALT, post-transport BUN, and the change level of BUN after transport as compared with those without cardiac arrest history. The donors with a history of cranial decompression surgery had significantly lower pre-transport AST, pre-transport ALT, and post-transport Cr as compared with those without a history of cranial decompression surgery. Conclusion: These results suggested that long-distance donor transportation may result in organ function deterioration, especially for donors with a cardiac arrest history. Donors with a history of intracranial decompression surgery can alleviate this problem.

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“…The conditions and duration of organ procurement trips can significantly affect the durability of organs due to various stressors, including shifts in temperature and vibration. Studies have shown a correlation between the duration and conditions of procurement trips and the functional outcomes of transplantations, suggesting that smoother organ procurements promise more prolonged survival of transplanted organs [1,25].…”

Section: Dealing With Health Illiteracy: "Did You Transplant the Dono...mentioning

confidence: 99%

Navigating Cultural Challenges in Transplant Surgery: Insights from Turkish Surgeons

Karataş,

Balas

2024

Healthcare

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To achieve expertise, transplant surgeons in Turkiye undergo rigorous training, including medical school, residency, compulsory service, and extensive training in transplant surgery. Despite their high academic and clinical knowledge level, success in transplant surgery heavily depends on cultural competency. Through semi-structured interviews with 21 transplant surgeons specializing in kidney and liver transplants in Ankara, this study reveals how health illiteracy, culture, and folklore create significant barriers. Surgeons navigate these challenges while enduring harsh working conditions. This research highlights the critical role of cultural competency in transplant surgery, emphasizing the necessity for surgeons to understand and address the diverse cultural needs of their patients. Key findings indicate that surgeons must balance medical expertise with cultural sensitivity to deliver effective care. This study identifies four main cultural barriers: spiritual trust, family politics, health illiteracy, and subcultural incompetency. Effective transplant surgery requires a combination of theoretical proficiency and cultural awareness to meet a patient’s needs and improve surgical outcomes.

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Effect of airplane transport of donor livers on post-liver transplantation survival

Cited by 7 publications

References 11 publications

Asian Pacific Association for the Study of the Liver clinical practice guidelines on liver transplantation

Asian Pacific Association for the Study of the Liver clinical practice guidelines on liver transplantation

The Effect of Donor Transportation on the Function of Donor’s Organs

Navigating Cultural Challenges in Transplant Surgery: Insights from Turkish Surgeons

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