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Timing of Organ Procurement From Brain-Dead Donors Associates With Short- and Long-Term Outcomes After Liver Transplantation
Brain death-induced cytokine storm is thought to harm transplantable organs. However, longer procurement times have been associated with non-inferior or better outcomes in kidney, heart, and lung transplants, while optimal procurement time for liver allografts is unknown. Our aim was to analyze the...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9472133/ https://www.ncbi.nlm.nih.gov/pubmed/36118016 http://dx.doi.org/10.3389/ti.2022.10364 |
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author | Eerola, Verner Helanterä, Ilkka Åberg, Fredrik Lempinen, Marko Mäkisalo, Heikki Nordin, Arno Isoniemi, Helena Sallinen, Ville |
author_facet | Eerola, Verner Helanterä, Ilkka Åberg, Fredrik Lempinen, Marko Mäkisalo, Heikki Nordin, Arno Isoniemi, Helena Sallinen, Ville |
author_sort | Eerola, Verner |
collection | PubMed |
description | Brain death-induced cytokine storm is thought to harm transplantable organs. However, longer procurement times have been associated with non-inferior or better outcomes in kidney, heart, and lung transplants, while optimal procurement time for liver allografts is unknown. Our aim was to analyze the association of time interval from brain death to organ procurement with liver allograft outcomes in two nationwide cohorts. The association of procurement interval with graft survival and short-term complications was analysed in multivariable models. Altogether 643 and 58,017 orthotopic liver transplantations from brain-dead donors were included from Finland between June 2004 and December 2017 and the US between January 2008 and August 2018, respectively. Median time from brain death to organ procurement was 10.5 h in Finland and 34.6 h in the US. Longer interval associated with better graft survival (non-linearly, p = 0.016) and less acute rejections (OR 0.935 95% CI 0.894–0.978) in the US cohort, and better early allograft function (p = 0.005; Beta −0.048 95% CI −0.085 −(−0.011)) in the Finnish cohort, in multivariable models adjusted with Donor Risk Index, recipient age, Model for End-Stage Liver Disease and indication for transplantation. Progressive liver injury after brain death is unlikely. Rushing to recover seems unnecessary; rest and repair might prove beneficial. |
format | Online Article Text |
id | pubmed-9472133 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-94721332022-09-15 Timing of Organ Procurement From Brain-Dead Donors Associates With Short- and Long-Term Outcomes After Liver Transplantation Eerola, Verner Helanterä, Ilkka Åberg, Fredrik Lempinen, Marko Mäkisalo, Heikki Nordin, Arno Isoniemi, Helena Sallinen, Ville Transpl Int Health Archive Brain death-induced cytokine storm is thought to harm transplantable organs. However, longer procurement times have been associated with non-inferior or better outcomes in kidney, heart, and lung transplants, while optimal procurement time for liver allografts is unknown. Our aim was to analyze the association of time interval from brain death to organ procurement with liver allograft outcomes in two nationwide cohorts. The association of procurement interval with graft survival and short-term complications was analysed in multivariable models. Altogether 643 and 58,017 orthotopic liver transplantations from brain-dead donors were included from Finland between June 2004 and December 2017 and the US between January 2008 and August 2018, respectively. Median time from brain death to organ procurement was 10.5 h in Finland and 34.6 h in the US. Longer interval associated with better graft survival (non-linearly, p = 0.016) and less acute rejections (OR 0.935 95% CI 0.894–0.978) in the US cohort, and better early allograft function (p = 0.005; Beta −0.048 95% CI −0.085 −(−0.011)) in the Finnish cohort, in multivariable models adjusted with Donor Risk Index, recipient age, Model for End-Stage Liver Disease and indication for transplantation. Progressive liver injury after brain death is unlikely. Rushing to recover seems unnecessary; rest and repair might prove beneficial. Frontiers Media S.A. 2022-08-31 /pmc/articles/PMC9472133/ /pubmed/36118016 http://dx.doi.org/10.3389/ti.2022.10364 Text en Copyright © 2022 Eerola, Helanterä, Åberg, Lempinen, Mäkisalo, Nordin, Isoniemi and Sallinen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Health Archive Eerola, Verner Helanterä, Ilkka Åberg, Fredrik Lempinen, Marko Mäkisalo, Heikki Nordin, Arno Isoniemi, Helena Sallinen, Ville Timing of Organ Procurement From Brain-Dead Donors Associates With Short- and Long-Term Outcomes After Liver Transplantation |
title | Timing of Organ Procurement From Brain-Dead Donors Associates With Short- and Long-Term Outcomes After Liver Transplantation |
title_full | Timing of Organ Procurement From Brain-Dead Donors Associates With Short- and Long-Term Outcomes After Liver Transplantation |
title_fullStr | Timing of Organ Procurement From Brain-Dead Donors Associates With Short- and Long-Term Outcomes After Liver Transplantation |
title_full_unstemmed | Timing of Organ Procurement From Brain-Dead Donors Associates With Short- and Long-Term Outcomes After Liver Transplantation |
title_short | Timing of Organ Procurement From Brain-Dead Donors Associates With Short- and Long-Term Outcomes After Liver Transplantation |
title_sort | timing of organ procurement from brain-dead donors associates with short- and long-term outcomes after liver transplantation |
topic | Health Archive |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9472133/ https://www.ncbi.nlm.nih.gov/pubmed/36118016 http://dx.doi.org/10.3389/ti.2022.10364 |
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