Retrospective analysis of the causes of rejection of potential donors for living related liver transplantation.
BACKGROUND
A major prerequisite for living related liver transplantation is to ensure both donor safety and optimal graft quality. Therefore, excluding unsuitable donor candidates should be an important priority of the transplant team.


OBJECTIVE
To analyze the criteria for exclusion of potential living related liver donors.


METHODS
From November 2000 to March 2005, 327 potential living related donors for 136 potential recipients for liver transplantation were screened and worked up at the Liver Transplant Center, King Abdul Aziz Medical City. They were evaluated in a stepwise manner, including medical, physical, laboratory, psychosocial, and imaging assessment. Data regarding potential donors were retrospectively reviewed. Reasons for rejection of disqualified donors were analyzed.


RESULTS
Out of the 327 potential donors, 223 (68.2%) were rejected at an early stage. A total of 104 cases (31.8%) had computed tomographic (CT) volumetry and/or magnetic resonance cholangiography (MRCP). While 44 (42.3% of those who had CT volumetry and/or MRCP) had their workup completed and proved to be suitable candidates, 24 (23%) went for surgery. Causes for donor rejection were classified as donor-related factors (inadequate volume, unsafe anatomy, abnormal liver function tests, medical/psychiatric, fatty liver, etc.; n = 191) and recipient-related factors (too ill, died, received cadaveric transplant, etc.; n = 112).


CONCLUSIONS
In our experience, as well as in those from other centers, a small proportion of potential donors prove to be satisfactory candidates. Therefore, strict adherence to a stepwise evaluation process is of utmost importance, so unsuitable potential donors can be disqualified, as early as possible during workup.
Abdullah
Khalid
K
Liver Transplant Center, King Abdul Aziz Medical City, Riyadh, Saudi Arabia.
Abdeldayem
Hesham
H
Salama
Ibrahim Abdel-Kader
IA
Badah
Khaled
K
Al-Somali
Badriyah
B
Abdulkareem
Abdulmajeed
A