Personal experience with the procurement of 32 liver allografts

作     者：Guang-WenZhou Cheng-HongPeng Hong-WeiLi 

作者机构：DepartmentofSurgeryRuijinHospitalShanghaiSecondMedicalUniversityShanghai200025China 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2005年第11卷第25期

页      面：3939-3943页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Liver transplantation Liver procurement Donor Arterial anomalies 

摘      要：AIM: To introduce the American Pittsburgh s method of rapid liver procurement under the condition of brain death and factors influencing the quality of donor ***: To analyze 32 cases of allograft liver procurement retrospectively and observe the clinical outcome of orthotopic liver ***: Average age of donors was 38.24±12.78 years,with a male:female ratio of 23:9. The causes of brain death included 21 cases of trauma (65.63%) and nine cases of cerebrovascular accident (28.13%). Fourteen grafts (43.75%) had hepatic arterial anomalies, seven cases only right hepatic arterial anomalies (21.88%), five cases only left hepatic arterial anomalies (15.63%) and two cases of both right and left hepatic arterial anomalies (6.25%) among them. Eight cases (57.14%) of hepatic arterial anomalies required arterial reconstruction prior to transplantation. Of the 32 grafts evaluated for early function, 27 (84.38%) functioned well, whereas three (9.38%) functioned poorly and two (6.25%) failed to function at all. Only one recipient died after transplantation and thirty-one recipients recovered. Four recipients needed retransplantation. The variables associated with less than optimal function of the graft consisted of donor age (35.6±12.9 years vs 54.1±4.3 years, P0.05), duration of donor s stay in the intensive care unit (ICU) (3.5±2.4 d vs 7.4±2.1 d, P0.005), abnormal graft appearance (19.0% vs 100%, P0.05), and such recipient problems as vascular thromboses during or immediately following transplantation (89.3% vs 50.0%, P0.005).CONCLUSION: During liver procurement, complete heparization, perfusion in situ with localized low temperature and standard technique procedures are the basis ensuring the quality of the graft. The hepatic arterial anomalies should be taken care of to avoid injury. The donor age,duration of donor s staying in ICU, abnormal graft appearance and recipient problem are important factors influencing the quality of the liver graft.