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Liver Grafts with Major Extended Donor Criteria May Expand the Organ Pool for Patients with Hepatocellular Carcinoma

The major extended donor criteria (maEDC; steatosis >40%, age >65 years, and cold ischemia time >14 h) influence graft and patient outcomes after liver transplantation. Despite organ shortages, maEDC organs are often considered unsuitable for transplantation. We investigated the outcomes of...

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Autores principales: Lozanovski, Vladimir J., Kerr, Larissa T.B., Khajeh, Elias, Ghamarnejad, Omid, Pfeiffenberger, Jan, Hoffmann, Katrin, Chang, De-Hua, Mieth, Markus, Longerich, Thomas, Strobel, Oliver, Weiss, Karl Heinz, Büchler, Markus W., Mehrabi, Arianeb
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832253/
https://www.ncbi.nlm.nih.gov/pubmed/31618968
http://dx.doi.org/10.3390/jcm8101692
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author Lozanovski, Vladimir J.
Kerr, Larissa T.B.
Khajeh, Elias
Ghamarnejad, Omid
Pfeiffenberger, Jan
Hoffmann, Katrin
Chang, De-Hua
Mieth, Markus
Longerich, Thomas
Strobel, Oliver
Weiss, Karl Heinz
Büchler, Markus W.
Mehrabi, Arianeb
author_facet Lozanovski, Vladimir J.
Kerr, Larissa T.B.
Khajeh, Elias
Ghamarnejad, Omid
Pfeiffenberger, Jan
Hoffmann, Katrin
Chang, De-Hua
Mieth, Markus
Longerich, Thomas
Strobel, Oliver
Weiss, Karl Heinz
Büchler, Markus W.
Mehrabi, Arianeb
author_sort Lozanovski, Vladimir J.
collection PubMed
description The major extended donor criteria (maEDC; steatosis >40%, age >65 years, and cold ischemia time >14 h) influence graft and patient outcomes after liver transplantation. Despite organ shortages, maEDC organs are often considered unsuitable for transplantation. We investigated the outcomes of maEDC organ liver transplantation in patients with hepatocellular carcinoma (HCC). Two hundred and sixty-four HCC liver transplant patients were eligible for analysis. Risk factor analysis was performed for early allograft dysfunction; primary nonfunction; 30-day and 90-day graft failure; and 30-day, 90-day, and 1-year patient mortality. One-year graft survival was higher in recipients of no-maEDC grafts. One-year patient survival did not differ between the recipients of no-maEDC and maEDC organs. The univariate and multivariate analyses revealed no association between maEDC grafts and one-year patient mortality. Graft survival differed between the recipients of no-maEDC and maEDC organs after correcting for a laboratory model of end-stage liver disease (labMELD) score with a cut-off value of 20, but patient survival did not. Patient survival did not differ between recipients who did and did not meet the Milan criteria and who received grafts with and without maEDC. Instead of being discarded, maEDC grafts may expand the organ pool for patients with HCC without impairing patient survival or recurrence-free survival.
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spelling pubmed-68322532019-11-21 Liver Grafts with Major Extended Donor Criteria May Expand the Organ Pool for Patients with Hepatocellular Carcinoma Lozanovski, Vladimir J. Kerr, Larissa T.B. Khajeh, Elias Ghamarnejad, Omid Pfeiffenberger, Jan Hoffmann, Katrin Chang, De-Hua Mieth, Markus Longerich, Thomas Strobel, Oliver Weiss, Karl Heinz Büchler, Markus W. Mehrabi, Arianeb J Clin Med Article The major extended donor criteria (maEDC; steatosis >40%, age >65 years, and cold ischemia time >14 h) influence graft and patient outcomes after liver transplantation. Despite organ shortages, maEDC organs are often considered unsuitable for transplantation. We investigated the outcomes of maEDC organ liver transplantation in patients with hepatocellular carcinoma (HCC). Two hundred and sixty-four HCC liver transplant patients were eligible for analysis. Risk factor analysis was performed for early allograft dysfunction; primary nonfunction; 30-day and 90-day graft failure; and 30-day, 90-day, and 1-year patient mortality. One-year graft survival was higher in recipients of no-maEDC grafts. One-year patient survival did not differ between the recipients of no-maEDC and maEDC organs. The univariate and multivariate analyses revealed no association between maEDC grafts and one-year patient mortality. Graft survival differed between the recipients of no-maEDC and maEDC organs after correcting for a laboratory model of end-stage liver disease (labMELD) score with a cut-off value of 20, but patient survival did not. Patient survival did not differ between recipients who did and did not meet the Milan criteria and who received grafts with and without maEDC. Instead of being discarded, maEDC grafts may expand the organ pool for patients with HCC without impairing patient survival or recurrence-free survival. MDPI 2019-10-15 /pmc/articles/PMC6832253/ /pubmed/31618968 http://dx.doi.org/10.3390/jcm8101692 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lozanovski, Vladimir J.
Kerr, Larissa T.B.
Khajeh, Elias
Ghamarnejad, Omid
Pfeiffenberger, Jan
Hoffmann, Katrin
Chang, De-Hua
Mieth, Markus
Longerich, Thomas
Strobel, Oliver
Weiss, Karl Heinz
Büchler, Markus W.
Mehrabi, Arianeb
Liver Grafts with Major Extended Donor Criteria May Expand the Organ Pool for Patients with Hepatocellular Carcinoma
title Liver Grafts with Major Extended Donor Criteria May Expand the Organ Pool for Patients with Hepatocellular Carcinoma
title_full Liver Grafts with Major Extended Donor Criteria May Expand the Organ Pool for Patients with Hepatocellular Carcinoma
title_fullStr Liver Grafts with Major Extended Donor Criteria May Expand the Organ Pool for Patients with Hepatocellular Carcinoma
title_full_unstemmed Liver Grafts with Major Extended Donor Criteria May Expand the Organ Pool for Patients with Hepatocellular Carcinoma
title_short Liver Grafts with Major Extended Donor Criteria May Expand the Organ Pool for Patients with Hepatocellular Carcinoma
title_sort liver grafts with major extended donor criteria may expand the organ pool for patients with hepatocellular carcinoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832253/
https://www.ncbi.nlm.nih.gov/pubmed/31618968
http://dx.doi.org/10.3390/jcm8101692
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