title: Does procurement technique affect posttransplant graft function in deceased donor liver transplantation?
abstract: BACKGROUND
  Various techniques have been described deceased donor liver transplantation (DDLT) procurement. One is a technique whereby almost total dissection is done in the porta hepatis and perihepatic detachment is carried out before cross-clamping the donor aorta. In another approach, after the donor aorta is cross-clamped, rapid and minimal en bloc dissection is performed with minimal manipulation. We evaluated early posttransplant graft function among liver procurement techniques.
  
  
  METHODS
  Between January 2008 and August 2012, we performed 45 consecutive adult DDLTs. One patient was excluded from this analysis due to early death from sepsis after transplantation. The 44 included patients were divided into two cohorts according to the procurement technique: A warm dissection (n = 23; 52%) and a cold dissection group (n = 21; 48%). We compared early posttransplant graft function using the aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (T-bil), and prothrombin time (PT) values of the two groups from the first to seventh postoperative day.
  
  
  RESULTS
  The AST values in the warm group were significantly greater than those in the cold group on postoperative days 3 and 5. In addition, the ALT values in the warm group were greater than those in the cold group on postoperative days 4, 5, and 6. Moreover, the T-bil values in the warm group were greater than those in the cold group on postoperative days 2, 3, 4, 5, 6, and 7. However, there were no differences in PT values.
  
  
  CONCLUSIONS
  During liver procurement for DDLT, rapid en bloc procurement with minimal manipulation after clamping the donor aorta achieved better early graft function posttransplantation.
authors.affiliation: Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: S W
authors.initials: SW
authors.lastname: Jung
authors.forename: D-S
authors.initials: DS
authors.lastname: Kim
authors.forename: Y D
authors.initials: YD
authors.lastname: Yu
authors.forename: W B
authors.initials: WB
authors.lastname: Ji
authors.forename: P J
authors.initials: PJ
authors.lastname: Park
authors.forename: S B
authors.initials: SB
authors.lastname: Choi
authors.forename: J W
authors.initials: JW
authors.lastname: Park
authors.forename: S Y
authors.initials: SY
authors.lastname: Yoon
authors.forename: H J
authors.initials: HJ
authors.lastname: Han
authors.forename: T J
authors.initials: TJ
authors.lastname: Song
authors.forename: S Y
authors.initials: SY
authors.lastname: Choi
authors.forename: S O
authors.initials: SO
authors.lastname: Suh
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011517:Prothrombin Time; D014019:Tissue Donors
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin