Does the presence of a measurable blood alcohol level in a potential organ donor affect the outcome of liver transplantation?
The widespread application of hepatic transplantation has created a tremendous demand for donor organs. An assessment of donor parameters is thought to be important in selecting good donors; however, the criteria utilized have not been standardized. This study was performed to determine the effect of a measurable donor blood alcohol level on graft survival. Fifty-two patients who underwent orthotopic liver transplantation at the University of Pittsburgh were included in the study. Twenty-five patients received liver grafts from donors having a blood alcohol level between 0.04 and 0.4 g/l with a mean of 0.17 g/l. Twenty-seven patients received a liver graft from a donor who had no measurable blood alcohol. There were no differences between these two groups of donors regarding the time of initial hospitalization until the time of donation. Graft failure within the first 30 days was 24% for those receiving an organ from an alcohol-positive donor as compared with 22.2% in those receiving an organ from an alcohol negative donor. The recipient mortality rate was 16% and 11%, respectively. No relationships between the donor blood alcohol level and organ performance, frequency of primary graft nonfunction, or number of episodes of acute cellular rejection were evident. Based upon these data, the presence of a measurable blood alcohol level in a donor should not mitigate against organ donation.
Hassanein
T I
TI
Division of Gastroenterology, University of Pittsburgh, School of Medicine, Pennsylvania 15213.
Gavaler
J S
JS
Fishkin
D
D
Gordon
R
R
Starzl
T E
TE
Van Thiel
D H
DH
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D000431:Ethanol / Q000493:pharmacokinetics*; D005500:Follow-Up Studies; D006085:Graft Survival / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000502:physiology*; D011183:Postoperative Complications / Q000503:physiopathology*; D011517:Prothrombin Time; D012189:Retrospective Studies; D014019:Tissue Donors
D000431:Ethanol; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin