[The role of marginal donors in liver transplantation. The Hungarian experience].
Availability of suitable donor organs has always limited liver transplantations. Use of marginal donors (Extended Donor Criteria) for liver transplantation is an alternative to overcome the organ shortage. The aim of this study was to analyze the characteristics of organ donation in Hungary with special regard to marginal donors.


METHODS
We reviewed data from donors and recipients between January 2003 and December 2008 retrospectively. Extended donor criteria were adopted from international recommendations.


RESULTS
During this period, 1078 donors were reported to the clinic. 835 (77.4%) donors were excluded from liver transplantation and 243 (22.6%) were implanted. From the 243 transplantations 40 recipients (16%) received marginal graft, 203 (84%) received non-marginal graft. Extended Donor Criteria status had no negative impact on the patient and graft survival, postoperative graft dysfunction, and other complications. Recurrence of Hepatitis C occurred earlier in those patients who received marginal graft.


CONCLUSIONS
There is an increasing number of patients waiting for liver transplantation in Hungary. There is no significant difference in morbidity and mortality of patients receiving marginal or non-marginal graft. Use of marginal grafts should be avoided in Hepatitis C virus positive recipients. Acceptance of older donors for liver transplantation should be considered.
Nemes
Balázs
B
Semmelweis Egyetem, Altalános Orvostudományi Kar Transzplantációs és Sebészeti Klinika, Budapest. nemes@trans.sote.hu
Gelley
Fanni
F
Zádori
Gergely
G
Görög
Dénes
D
Fehérvári
Imre
I
Jakab
Katalin
K
Fazakas
János
J
Mándli
Tamás
T
Gerlei
Zsuzsa
Z
Sárváry
Eniko
E
Doros
Attila
A
Kóbori
László
L
D000367:Age Factors; D015992:Body Mass Index; D046148:Donor Selection / Q000592:standards*; D006085:Graft Survival; D006526:Hepatitis C / Q000175:diagnosis; D006801:Humans; D006814:Hungary; D006955:Hypernatremia / Q000150:complications; D007022:Hypotension / Q000150:complications; D007362:Intensive Care Units; D007511:Ischemia / Q000150:complications; D007902:Length of Stay; D008111:Liver Function Tests; D016031:Liver Transplantation; D012008:Recurrence; D016019:Survival Analysis; D014019:Tissue Donors / Q000600:supply & distribution; D009927:Tissue and Organ Procurement / Q000592:standards*