Causes of liver disqualiﬁcation in cadaveric donor population in department of general transplant and liver surgery of Medical University of Warsaw (2003–2008)
M Urban, R Stankiewicz, M Galas, B Cieślak
Ann Transplant 2009; 14(1): 42-42
Background: Increasing number of transplantations in Poland shows the growing problem of organ shortage. It is connected not only with unsatisfactory number of donors, but also with remarkable amount of rejected grafts.
Material/Methods: We retrospectively analyzed information about 798 potential deceased liver donors referred to the department's coordinator from 2003 to
2008. 537 liver transplantations were performed, which was 67% of the total number of organ donor notifications. Disqualification rate ranged from 44% in 2003 to 24% in the last year. According to the time of disqualification during coordinating procedure we classified causes of retrieval into three groups: 1) donor's disqualification - before organ harvesting (based on abnormal biochemical blood tests' results, hemodynamic donor condition or risk of neoplasmatic process); 2) intraoperative disqualification (e.g. suspicion of abdominal malignant tumour or macroscopic liver evaluation); 3) organ disqualification - based on histopathological examination.
Results: During analyzed period 261 donors out of 798 donor notifications were disqualified, which stated 33%. The first of above group was the greatest. Before harvesting 65% (n=171) livers were excluded from the transplantation. After intraoperative evaluation 19% (n= 49) of livers were rejected, while histopathological results disqualified 16% (n=41) of grafts.
Conclusions: Organ enrolment is based on multistage qualifying process.
Decreasing number of disqualifications is probably connected with extending donor criteria and better education among medical teams recruiting potential cadaveric donors.
Keywords: Deceased Donor, Liver Transplantation, Organ Procurement