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Expanding the liver donor pool worldwide with hepatitis C infected livers, is it the time?

World Journal of Transplantation 2024年第2期14卷 13-27页

作者： Mai Hashem Mohammed A Medhat Doaa Abdeltawab Nahed A Makhlouf Fellow of Tropical Medicine and Gastroenterology Assiut University HospitalAssiut 71515Egypt Department of Tropical Medicine and Gastroenterology Faculty of MedicineAssiut UniversityAssiut 71515Egypt Department of Tropical Medicine and Gastroenterology Al-Rajhi Liver HospitalAssiut UniversityAssiut 71515Egypt

Liver transplantation(LT)provides a life-saving option for cirrhotic patients with complications and hepatocellular *** the increasing number of liver transplants performed each year,the number of LT candidates on the waitlist remains unchanged due to an imbalance between donor organ supply and the demand which increases the waitlist time and *** donor liver transplant had a great role in increasing the donor pool and shortened waitlist time for LT ***,further strategies can be implemented to increase the pool of potential donors in deceased donor LT,such as reducing the rate of organ *** hepatitis C virus(HCV)seropositive liver grafts is one of the expanded donor organ criteria.A yearly increase of hundreds of transplants is anticipated as a result of maximizing the utilization of HCV-positive organs for HCV-negative ***-acting antiviral therapy's efficacy has revolutionized the treatment of HCV infection and the use of HCV-seropositive donors in *** American Society of Transplantation advises against performing transplants from HCV-infected liver donors(D+)into HCV-negative recipient(R-)unless under Institutional Review Board-approved study rules and with full informed consent of the knowledge gaps associated with such *** selection of patients to be transplanted with HCV-infected grafts and confirming their access to direct-acting antivirals if needed is *** and international consensuses are needed to regulate this process to ensure the maximum benefit and the least adverse events.

关键词： donor pool Hepatitis C-viremic organs Non-viremic organs Direct acting antivirals Hepatitis C virus treated Liver transplantation

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The Dallas Donation after Circulatory Death Transplantation Summit:expanding donation after circulatory death procedures through process improvement,broader utilization,and innovation

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Hepatobiliary Surgery and Nutrition 2024年第5期13卷 824-836,I0009页

作者： Michele Finotti Anji Wall Anthony D’Alessandro Gary Schwartz Chris Sonnenday David Goldberg Ashish Shah Peter Friend Jeff P.Orlowski Greg McKenna Steve Newton Brad Adams William C.Chapman Amit Mathur Marwan Abouljoud Tim Pruett Amelia Hessheimer James F.Trotter Sumeet K.Asrani Giuliano Testa Simmons Transplant Institute Baylor University Medical CenterDallasTXUSA Hepatobiliary and General Surgery Unit Regional Hospital TrevisoDISCOGUniversity of PaduaPaduaItaly Division of Transplantation Department of SurgeryUniversity of Wisconsin School of Medicine and Public HealthMadisonWIUSA Department of Thoracic Surgery and Lung Transplantation Baylor University Medical CenterCenter for Advanced Heart and Lung DiseaseDallasTXUSA Department of Surgery University of MichiganAnn ArborMIUSA Division of Digestive Health and Liver Diseases Department of MedicineUniversity of Miami Miller School of MedicineMiamiFLUSA Department of Cardio-Thoracic Surgery Vanderbilt University Medical CenterNashvilleTNUSA Nuffield Department of Surgical Sciences University of OxfordOxfordUK LifeShare Transplant donor Services of Oklahoma Oklahoma CityOKUSA Administration Baylor University Medical CenterDallasTXUSA Southwest Transplant Alliance DallasTXUSA Department of Surgery/Transplantation Washington UniversitySt.LouisMOUSA Division of Transplant Surgery Department of SurgeryMayo Clinic ArizonaAlix School of MedicinePhoenixAZUSA Divisions of Transplant and Hepatobiliary Surgery Henry Ford HospitalDetroitMIUSA Department of Surgery University of MinnesotaMinneapolisMNUSA General and Digestive Surgery Hospital Universitario La PazIdiPAZMadridSpain

Despite a significant increase in utilization over the past decade,the number of donation after circulatory death(DCD)organs that are procured and transplanted in the United States(US)remains well below its *** is still room for expansion,as utilizing DCD organs to the fullest extent is currently the most viable solution to the persistent mismatch between supply and demand in *** convened a multidisciplinary transplantation summit to examine various aspects of DCD,with faculty members from around the world with clinical and academic interest in DCD donation and transplantation,including abdominal and cardiothoracic surgeons,organ procurement organization directors,hepatologists,and *** conference focused on identifying barriers to DCD organ utilization and strategies to overcome these *** divide the barriers to DCD utilization into three mains categories:(Ⅰ)policy and process variation;(II)logistical and transportation challenges;and(Ⅲ)higher risk perceptions related to DCD *** each barrier,we proposed a variety of solutions,providing an overview of the status of DCD donation in the US and suggestions on how to increase the use of *** is a specific focus on ex situ machine perfusion,normothermic regional perfusion,and other opportunities to expand DCD utilization without negatively impacting recipient outcomes.

关键词： Donation after circulatory death donation(DCD donation) marginal graft donor pool machine perfusion(MP)

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