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Extended criteria brain-dead organ donors: Prevalence and impact on the utilisation of livers for transplantation in Brazil

BACKGROUND: Despite its association with higher postoperative morbidity and mortality, the use of extended criteria donor (ECD) livers for transplantation has increased globally due to the high demand for the procedure. AIM: To investigate the prevalence of ECD in donation after brain death (DBD) an...

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Autores principales: Braga, Victoria S, Boteon, Amanda P C S, Paglione, Heloisa B, Pecora, Rafael A A, Boteon, Yuri L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10011911/
https://www.ncbi.nlm.nih.gov/pubmed/36926240
http://dx.doi.org/10.4254/wjh.v15.i2.255
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author Braga, Victoria S
Boteon, Amanda P C S
Paglione, Heloisa B
Pecora, Rafael A A
Boteon, Yuri L
author_facet Braga, Victoria S
Boteon, Amanda P C S
Paglione, Heloisa B
Pecora, Rafael A A
Boteon, Yuri L
author_sort Braga, Victoria S
collection PubMed
description BACKGROUND: Despite its association with higher postoperative morbidity and mortality, the use of extended criteria donor (ECD) livers for transplantation has increased globally due to the high demand for the procedure. AIM: To investigate the prevalence of ECD in donation after brain death (DBD) and its impact on organ acceptance for transplantation. METHODS: Retrospective analysis of DBD organ offers for liver transplantation between 2017 and 2020 in a high-volume transplant centre. The incidence of the Eurotransplant risk factors to define an ECD (ET-ECD) among DBD donors and the likelihood of organ acceptance over the years were analysed. The relationship between organ refusal for transplantation, the occurrence, and the number of ET-ECD was assessed by simple and multiple logistic regression adjustment. RESULTS: A total of 1619 organ donors were evaluated. Of these, 78.31% (n = 1268) had at least one ET-ECD criterion. There was an increase in the acceptance of ECD DBD organs for transplantation (1 criterion: from 23.40% to 31.60%; 2 criteria: from 13.10% to 27.70%; 3 criteria: From 6.30% to 13.60%). For each addition of one ET-ECD variable, the estimated chance of organ refusal was 64.4% higher (OR 1.644, 95%CI 1.469-1.839, P < 0.001). Except for the donor serum sodium > 165 mmol/L (P = 0.310), all ET-ECD criteria increased the estimated chance of organ refusal for transplantation. CONCLUSION: A high prevalence of ECD DBD was observed. Despite the increase in their utilisation, the presence and the number of extended donor criteria were associated with an increased likelihood of their refusal for transplantation.
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spelling pubmed-100119112023-03-15 Extended criteria brain-dead organ donors: Prevalence and impact on the utilisation of livers for transplantation in Brazil Braga, Victoria S Boteon, Amanda P C S Paglione, Heloisa B Pecora, Rafael A A Boteon, Yuri L World J Hepatol Retrospective Cohort Study BACKGROUND: Despite its association with higher postoperative morbidity and mortality, the use of extended criteria donor (ECD) livers for transplantation has increased globally due to the high demand for the procedure. AIM: To investigate the prevalence of ECD in donation after brain death (DBD) and its impact on organ acceptance for transplantation. METHODS: Retrospective analysis of DBD organ offers for liver transplantation between 2017 and 2020 in a high-volume transplant centre. The incidence of the Eurotransplant risk factors to define an ECD (ET-ECD) among DBD donors and the likelihood of organ acceptance over the years were analysed. The relationship between organ refusal for transplantation, the occurrence, and the number of ET-ECD was assessed by simple and multiple logistic regression adjustment. RESULTS: A total of 1619 organ donors were evaluated. Of these, 78.31% (n = 1268) had at least one ET-ECD criterion. There was an increase in the acceptance of ECD DBD organs for transplantation (1 criterion: from 23.40% to 31.60%; 2 criteria: from 13.10% to 27.70%; 3 criteria: From 6.30% to 13.60%). For each addition of one ET-ECD variable, the estimated chance of organ refusal was 64.4% higher (OR 1.644, 95%CI 1.469-1.839, P < 0.001). Except for the donor serum sodium > 165 mmol/L (P = 0.310), all ET-ECD criteria increased the estimated chance of organ refusal for transplantation. CONCLUSION: A high prevalence of ECD DBD was observed. Despite the increase in their utilisation, the presence and the number of extended donor criteria were associated with an increased likelihood of their refusal for transplantation. Baishideng Publishing Group Inc 2023-02-27 2023-02-27 /pmc/articles/PMC10011911/ /pubmed/36926240 http://dx.doi.org/10.4254/wjh.v15.i2.255 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Cohort Study
Braga, Victoria S
Boteon, Amanda P C S
Paglione, Heloisa B
Pecora, Rafael A A
Boteon, Yuri L
Extended criteria brain-dead organ donors: Prevalence and impact on the utilisation of livers for transplantation in Brazil
title Extended criteria brain-dead organ donors: Prevalence and impact on the utilisation of livers for transplantation in Brazil
title_full Extended criteria brain-dead organ donors: Prevalence and impact on the utilisation of livers for transplantation in Brazil
title_fullStr Extended criteria brain-dead organ donors: Prevalence and impact on the utilisation of livers for transplantation in Brazil
title_full_unstemmed Extended criteria brain-dead organ donors: Prevalence and impact on the utilisation of livers for transplantation in Brazil
title_short Extended criteria brain-dead organ donors: Prevalence and impact on the utilisation of livers for transplantation in Brazil
title_sort extended criteria brain-dead organ donors: prevalence and impact on the utilisation of livers for transplantation in brazil
topic Retrospective Cohort Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10011911/
https://www.ncbi.nlm.nih.gov/pubmed/36926240
http://dx.doi.org/10.4254/wjh.v15.i2.255
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