title: Extended criteria liver donation and transplant recipient consent: the European experience.
abstract: The organization known as ELPAT (Ethical, Legal and Psychological Aspects of Organ Transplantation) coordinated the distribution of an electronic questionnaire concerning the definition of extended criteria liver donation (ECD) and the implication for informed consent of transplant recipients to European liver transplant centers. Completed questionnaires were received from 30 centers in 13 countries. Twenty-eight centers accepted ECD liver donors. The criteria for defining a liver donor as ECD were: steatosis in 24 centers (85%); age up to 80 years in 23 centers (82%); serum sodium levels higher than 165 mmol/L in 17 centers (60%); intensive care unit stay with ventilation longer than 7 days in 16 centers (57%); serum glutamic oxalo-acitic transaminase levels higher than 90 U/L in 12 centers (42%); body mass indeces more than 30 in 10 centers (35%); serum glutamic pyruvic transaminase levels higher than 105 U/L in 10 centers (35%); serum bilirubin levels higher than 3 mg/dL in 10 centers (35%); and other criteria in 13 centers (46%). Twenty-three centers informed the transplant candidate of the ECD status of the donor: 10 centers (43%) when the patient registered for transplantation, 3 centers (14%) when an ECD liver became available, and 10 centers (43%) on both occasions. Ten centers required the liver transplant candidate to sign a special consent form. Ten centers informed the potential recipient of the donor's serology. Only three centers informed the potential recipient of any high risk behavior of the donor.
authors.affiliation: Sapienza Università di Roma, Rome, Italy. paolo.bruzzone@fastwebnet.it
authors.forename: P
authors.initials: P
authors.lastname: Bruzzone
authors.forename: D
authors.initials: D
authors.lastname: Giannarelli
authors.forename: A
authors.initials: A
authors.lastname: Nunziale
authors.forename: E
authors.initials: E
authors.lastname: Manna
authors.forename: S
authors.initials: S
authors.lastname: Coiro
authors.forename: F
authors.initials: F
authors.lastname: De Lucia
authors.forename: F M
authors.initials: FM
authors.lastname: Frattaroli
authors.forename: G
authors.initials: G
authors.lastname: Pappalardo
mesh_terms: D022126:Access to Information; D000367:Age Factors; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D003422:Critical Care; D046148:Donor Selection / Q000941:ethics; D005060:Europe; D005234:Fatty Liver / Q000150:complications; D019538:Health Care Surveys; D006304:Health Status; D006801:Humans; D007258:Informed Consent; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects / Q000941:ethics; D012121:Respiration, Artificial / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014019:Tissue Donors / Q000941:ethics / Q000600:supply & distribution*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers