Nguyen TK, Trinh HS, Luong TH, Ninh VK, Pham GA, Nguyen HH, Bui TN, Dang KK, Hoang T, Nguyen QN. Technical characteristics and quality of grafts in liver procurement from brain-dead donors: A single-center study in Vietnamese population.
Ann Med Surg (Lond) 2021;
69:102654. [PMID:
34429944 PMCID:
PMC8369000 DOI:
10.1016/j.amsu.2021.102654]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction
Donor liver graft quality plays an especially important role that contributes to the success of organ transplantation. Almost all local and international authors are interested in the techniques and results of transplantation, however, in Vietnam, there have not been any studies that report the results of liver procurement from brain-dead donors from a technical perspective as well as the morphology and function of the transplanted organ.
Materials and method
This study is descriptive cross-section study with analysis of retrospective occurrences of a series of cases of liver procurement from brain-dead donors from March 2010 to March 2020. All cases were proceeded the multiple organ procurement with warm liver dissection and in vivo cannulation and perfusion.
Results
The average age of brain-dead donors was 29.7 ± 10.7 (18–69), 92.16% of the harvested organs were of good quality macroscopically; and the rate of anatomical modification was 33.3% that occurred mostly in the left hepatic artery (LHA). Technically, warm dissection was proceeded in majority of cases (98,0%), the graft implantation was performed by this technique with mean cold ischemia time (CIT) of 190,0 ± 100,5 min and WIT of 74,0 ± 39,2 s. There were no complications relating to graft injuries occurring during procurement and no primary liver failure, good results accounted for 94.1% of the total number of transplants postoperatively.
Conclusion
Multiple organ procurement with warm liver dissection and in vivo cannulation and perfusion was a safe technique and may be effective by avoiding any donor's damages in cold-phase dissection.
Liver transplantation in brain-dead donors had developed rapidly in recent decades.
Several techniques were proceeded depend on experience and faculties of institute.
In vivo perfusion and warm dissection can avoid graft's damages in cold dissection.
Long-term follow-up is needed to evaluate quality of graft and overall survival.
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