title: Long-term results after liver transplantation with "livers that nobody wants" within Eurotransplant: a center's experience.
abstract: 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.
authors.affiliation: 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
authors.forename: G C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.forename: H
authors.initials: H
authors.lastname: Lang
authors.forename: F H
authors.initials: FH
authors.lastname: Saner
authors.forename: S
authors.initials: S
authors.lastname: Beckebaum
authors.forename: M
authors.initials: M
authors.lastname: Wandelt
authors.forename: E P
authors.initials: EP
authors.lastname: Molmenti
authors.forename: S
authors.initials: S
authors.lastname: Nadalin
authors.forename: J
authors.initials: J
authors.lastname: Treckmann
authors.forename: M
authors.initials: M
authors.lastname: Bockhorn
authors.forename: I
authors.initials: I
authors.lastname: Fouzas
authors.forename: M
authors.initials: M
authors.lastname: Malagó
authors.forename: G
authors.initials: G
authors.lastname: Gerken
authors.forename: C E
authors.initials: CE
authors.lastname: Broelsch
authors.forename: A
authors.initials: A
authors.lastname: Paul
mesh_terms: 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