Donor rejection before living donor liver transplantation: causes and cost effective analysis in an egyptian transplant center.
BACKGROUND
In the living donor liver transplant setting, the preoperative assessment of potential donors is important to ensure the donor safety.


OBJECTIVE
The aim of this study was to identify causes and costs of living liver-donors rejection in the donation process.


METHODS
From June 2010 to June 2012, all potential living liver donors for 66 liver transplant candidates were screened at the Ain Shams Center for Organ Transplantation. Potential donors were evaluated in 3 phases, and their data were reviewed to determine the causes and at which phase the donors were rejected.


RESULTS
One hundred and ninety two potential living liver donors, including 157 (81.7%) males, were screened for 66 potential recipients. Of these, 126 (65.6%) were disqualified for the donation. The causes of rejection were classified as surgical (9.5 %) or medical (90.5 %). Five donors (3.9 %) were rejected due to multiple causes. Factor V Leiden mutation was detected in 29 (23 %) rejected donors (P = 0.001), 25 (19.8 %) donors had positive results for hepatitis serology (P = 0.005), and 16 (12.7 %) tested positive for drug abuse. Portal vein trifurcation (n = 9, 7.1%) and small size liver graft estimated by CT volumetric analysis (n = 6, 4.8 %) were the main surgical causes which precluded the donation.


CONCLUSIONS
Among potential Egyptian living liver donors, Factor V Leiden mutation was a significant cause for live donor rejection. A stepwise approach to donor assessment was found to be cost-effective.
Ain Shams Center for Organ Transplant (ASCOT), Cairo, Egypt.
Mahmoud
M
El-Meteini
Ain Shams Center for Organ Transplant (ASCOT), Cairo, Egypt.
Hany
H
Dabbous
Ain Shams Center for Organ Transplant (ASCOT), Cairo, Egypt.
Mohammad
M
Sakr
Ain Shams Center for Organ Transplant (ASCOT), Cairo, Egypt.
Amany
A
Ibrahim
Ain Shams Center for Organ Transplant (ASCOT), Cairo, Egypt.
Iman
I
Fawzy
Ain Shams Center for Organ Transplant (ASCOT), Cairo, Egypt.
Mohamed
M
Bahaa
Ain Shams Center for Organ Transplant (ASCOT), Cairo, Egypt.
Amr
A
Abdelaal
Ain Shams Center for Organ Transplant (ASCOT), Cairo, Egypt.
Mohamed
M
Fathy
Ain Shams Center for Organ Transplant (ASCOT), Cairo, Egypt.
Hany
H
Said
Ain Shams Center for Organ Transplant (ASCOT), Cairo, Egypt.
Mohamed
M
Rady
Ain Shams Center for Organ Transplant (ASCOT), Cairo, Egypt.
Ahmed
A
El-Dorry
Liver Transplantation; Tissue Donors