Long-term results after liver transplantation with "livers that nobody wants" within Eurotransplant: a center's experience.
BACKGROUND
Orthotopic liver transplantation (OLT) represents the only curative treatment for end-stage liver disease, but its application is limited because of organ shortages. The purpose of this study was to review the long-term outcomes after OLT during a 2-year period of 45 rescue offers organs within Eurotransplant.


METHODS
Forty-five deceased donor liver allografts had been officially offered to and rejected by other transplantation centers 162 times prior to our acceptance. Data analysis addressed recurrence of primary disease, ischemic-type biliary lesions (ITBL), re-evaluation or relisting for OLT, re-OLT, as well as overall patient and graft survivals.


RESULTS
Six patients underwent retransplantation because of primary nonfunction (n = 4), hepatitis C recurrence (n = 1), and secondary biliary cirrhosis following ITBL (n = 1). Five additional patients developed ITBL and received endoscopic treatment. Currently, 34 patients are alive after a median follow-up of 44.5 months. Median graft survival is 43.2 months. Patient versus patient/first graft survival at 1, 3, and 5 years is 82%, 78%, and 74%, versus 76%, 69%, and 65%, respectively.


CONCLUSIONS
OLT with rescue organs is a reasonable policy, with acceptable long-term patient/graft survivals, providing a real expansion of the donor pool.
Sotiropoulos
G C
GC
Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, Essen, Germany; Department of General and Abdominal Surgery, Johannes Gutenberg University Hospital, Mainz, Germany. sotiropoulos@ach.klinik.uni-mainz.de
Lang
H
H
Saner
F H
FH
Beckebaum
S
S
Wandelt
M
M
Molmenti
E P
EP
Nadalin
S
S
Treckmann
J
J
Bockhorn
M
M
Fouzas
I
I
Malagó
M
M
Gerken
G
G
Broelsch
C E
CE
Paul
A
A
D000328:Adult; D002102:Cadaver; D005260:Female; D006085:Graft Survival; D006801:Humans; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012086:Reoperation / Q000706:statistics & numerical data; D015996:Survival Rate; D017741:Survivors; D014019:Tissue Donors / Q000600:supply & distribution*; D014184:Transplantation, Homologous; D016896:Treatment Outcome