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Transplantation after blunt trauma to the liver: a valuable option or just a "waste of organs"?

OBJECTIVE: Liver injury due to trauma is a rare indication for transplantation. The main indications in such cases were uncontrollable bleeding and insufficient hepatic function. Because of poor results, liver transplantation in these patients is occasionally described as "waste of organs"...

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Autores principales: Heuer, M, Kaiser, GM, Lendemans, S, Vernadakis, S, Treckmann, JW, Paul, A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3401001/
https://www.ncbi.nlm.nih.gov/pubmed/20554497
http://dx.doi.org/10.1186/2047-783X-15-4-169
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author Heuer, M
Kaiser, GM
Lendemans, S
Vernadakis, S
Treckmann, JW
Paul, A
author_facet Heuer, M
Kaiser, GM
Lendemans, S
Vernadakis, S
Treckmann, JW
Paul, A
author_sort Heuer, M
collection PubMed
description OBJECTIVE: Liver injury due to trauma is a rare indication for transplantation. The main indications in such cases were uncontrollable bleeding and insufficient hepatic function. Because of poor results, liver transplantation in these patients is occasionally described as "waste of organs", however based on insufficient data. This study aims to report our experience and to critically question the indication of transplantation in these patients. METHODS: All liver transplantations at our institution were reviewed retrospectively. This covered 1,529 liver transplants between September 1987 and December 2008. Of them, 6 transplants were performed due to motor-vehicle accidents which caused uncontrollable acute liver trauma in 4 patients. The patients' peri-operative course, short- and long-term outcomes were analyzed. RESULTS: Five deceased-donor liver transplantations (4 full size, 1 split) and 1 living donor (right) transplantation were performed. The median GCS score was 9/15; the median MELD score was 15. Postoperative complications were observed in 3 patients, requiring re-operation in 2. After a median (range) follow-up of 32.95 (10.3-55.6) months, 2 patients are alive and remain well on immunosuppression. CONCLUSION: Liver transplantation in patients with otherwise surgically uncontrollable acute liver injury can be indicated as a life saving procedure and can be performed successfully in highly selected cases.
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spelling pubmed-34010012012-07-21 Transplantation after blunt trauma to the liver: a valuable option or just a "waste of organs"? Heuer, M Kaiser, GM Lendemans, S Vernadakis, S Treckmann, JW Paul, A Eur J Med Res Research OBJECTIVE: Liver injury due to trauma is a rare indication for transplantation. The main indications in such cases were uncontrollable bleeding and insufficient hepatic function. Because of poor results, liver transplantation in these patients is occasionally described as "waste of organs", however based on insufficient data. This study aims to report our experience and to critically question the indication of transplantation in these patients. METHODS: All liver transplantations at our institution were reviewed retrospectively. This covered 1,529 liver transplants between September 1987 and December 2008. Of them, 6 transplants were performed due to motor-vehicle accidents which caused uncontrollable acute liver trauma in 4 patients. The patients' peri-operative course, short- and long-term outcomes were analyzed. RESULTS: Five deceased-donor liver transplantations (4 full size, 1 split) and 1 living donor (right) transplantation were performed. The median GCS score was 9/15; the median MELD score was 15. Postoperative complications were observed in 3 patients, requiring re-operation in 2. After a median (range) follow-up of 32.95 (10.3-55.6) months, 2 patients are alive and remain well on immunosuppression. CONCLUSION: Liver transplantation in patients with otherwise surgically uncontrollable acute liver injury can be indicated as a life saving procedure and can be performed successfully in highly selected cases. BioMed Central 2010-04-08 /pmc/articles/PMC3401001/ /pubmed/20554497 http://dx.doi.org/10.1186/2047-783X-15-4-169 Text en Copyright ©2010 I. Holzapfel Publishers
spellingShingle Research
Heuer, M
Kaiser, GM
Lendemans, S
Vernadakis, S
Treckmann, JW
Paul, A
Transplantation after blunt trauma to the liver: a valuable option or just a "waste of organs"?
title Transplantation after blunt trauma to the liver: a valuable option or just a "waste of organs"?
title_full Transplantation after blunt trauma to the liver: a valuable option or just a "waste of organs"?
title_fullStr Transplantation after blunt trauma to the liver: a valuable option or just a "waste of organs"?
title_full_unstemmed Transplantation after blunt trauma to the liver: a valuable option or just a "waste of organs"?
title_short Transplantation after blunt trauma to the liver: a valuable option or just a "waste of organs"?
title_sort transplantation after blunt trauma to the liver: a valuable option or just a "waste of organs"?
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3401001/
https://www.ncbi.nlm.nih.gov/pubmed/20554497
http://dx.doi.org/10.1186/2047-783X-15-4-169
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