Workgroup on expanded criteria organs for liver transplantation

Delmonico, Francis L.; Aufses, Arthur H.; Bozorgzadeh, Adel; Delgado-Vega, Debbie; Distant, Dale A.; Dubler, Nancy Neveloff; Emre, Sükrü; Feng, Sandy; Freeman, Richard B.; Fung, John J.; Gordon, Fredric D.; Hasz, Richard; Kinkhabwala, Milan; Lake, John R.; Merion, Robert M.; Orlowski, Jeffrey P.; Pinson, C. Wright; Powell, Tia; Sheiner, Patricia A.; Teperman, Lewis; Williams, Carla; Wong, Hui Hsing; Novello, Antonia C.; Osten, W; Wickens, Lisa; Barhydt, Nancy; Doesschate, Judy; Emrich, Sherry; Maynus, Dawn; McMurdo, Lisa; Valente, Kette D.

doi:10.1002/lt.20569

Cited by 31 publications

(1 citation statement)

References 2 publications

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“…Currently, there are a large number of predictive models for graft failure, all of which are heterogeneous because they use different criteria to select the independent variables. In general, the models have the same goal, which is to predict the development of liver dysfunction and provide an evidence-based tool that is useful during the liver graft selection process[3-5]. To ensure proper function of a liver graft, the hepatocellular critical mass is needed to maintain synthetic function and adequate blood supply through the vascular tree.…”

Section: Introductionmentioning

confidence: 99%

Hepatocellular carcinoma staging systems: Hong Kong liver cancer vs Barcelona clinic liver cancer in a Western population

Lominchar

Orue-Echebarria

Martín

et al. 2019

WJH

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BACKGROUNDEarly allograft dysfunction (EAD) after liver transplantation (LT) is an important cause of morbidity and mortality. To ensure adequate graft function, a critical hepatocellular mass is required in addition to an appropriate blood supply. We hypothesized that intraoperative measurement of portal venous and hepatic arterial flow may serve as a predictor in the diagnosis of EAD.AIMTo study whether hepatic flow is an independent predictor of EAD following LT.METHODSThis is an observational cohort study in a single institution. Hepatic arterial blood flow and portal venous blood flow were measured intraoperatively by transit flow. EAD was defined using the Olthoff criteria. Univariate and multivariate analyses were used to determine the intraoperative predictors of EAD. Survival analysis and prognostic factor analysis were performed using the Kaplan-Meier and Cox regression models.RESULTSA total of 195 liver transplant procedures were performed between January 2008 and December 2014 in 188 patients. A total of 54 (27.7%) patients developed EAD. The median follow-up was 39 mo. Portal venous flow, hepatic arterial flow (HAF) and total hepatic arterial flow were associated with EAD in both the univariate and multivariate analyses. HAF is an independent prognostic factor for 30-d patient mortality.CONCLUSIONIntraoperative measurement of blood flow after reperfusion appears to be a predictor of EAD; Moreover, HAF should be considered a predictor of 30-d patient mortality.

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Section: Introductionmentioning

confidence: 99%

Hepatocellular carcinoma staging systems: Hong Kong liver cancer vs Barcelona clinic liver cancer in a Western population

Lominchar

Orue-Echebarria

Martín

et al. 2019

WJH

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Report of the Paris consensus meeting on expanded criteria donors in liver transplantation

Durand¹,

Renz²,

Alkofer³

et al. 2008

Liver Transpl

279

239

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Because of organ shortage and a constant imbalance between available organs and candidates for liver transplantation, expanded criteria donors are needed. Experience shows that there are wide variations in the definitions, selection criteria, and use of expanded criteria donors according to different geographic areas and different centers. Overall, selection criteria for donors have tended to be relaxed in recent years. Consensus recommendations are needed. This article reports the conclusions of a consensus meeting held in Paris in March 2007 with the contribution of experts from Europe, the United States, and Asia. Definitions of expanded criteria donors with respect to donor variables (including age, liver function tests, steatosis, infections, malignancies, and heart-beating versus non-heart-beating, among others) are proposed. It is emphasized that donor quality represents a continuum of risk rather than "good or bad." A distinction is made between donor factors that generate increased risk of graft failure and factors independent of graft function, such as transmissible infectious disease or donor-derived malignancy, that may preclude a good outcome. Updated data concerning the risks associated with different donor variables in different recipient populations are given. Recommendations on how to safely expand donor selection criteria are proposed.

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Increased donor risk: Who should bear the burden?

Feng

2009

Liver Transpl

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Workgroup on expanded criteria organs for liver transplantation

Cited by 31 publications

References 2 publications

Hepatocellular carcinoma staging systems: Hong Kong liver cancer vs Barcelona clinic liver cancer in a Western population

Hepatocellular carcinoma staging systems: Hong Kong liver cancer vs Barcelona clinic liver cancer in a Western population

Report of the Paris consensus meeting on expanded criteria donors in liver transplantation

Increased donor risk: Who should bear the burden?

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