title: Donor selection criteria for liver transplantation in Argentina: are current standards too rigorous?
abstract: Organ shortage is the major limitation for the growth of deceased donor liver transplant worldwide. One strategy to ameliorate this problem is to maximize the liver utilization rate. To assess predictors of liver utilization in Argentina. The national database was used to analyze transplant activity in 2010. Donor, recipient, and transplant variables were evaluated as predictors of graft utilization of number of rejected donor offers before grafting and with the occurrence of primary nonfunction (PNF) or early post-transplant mortality (EM). Of the 582 deceased donors, 293 (50.3%) were recovered for liver transplant. Variables associated with the nonrecovery of the liver were age ≥46 years, umbilical perimeter ≥92 cm, organ procurement outside Gran Buenos Aires, AST ≥42 U/l and ALT ≥29 U/l. The median number of rejected offers before grafting was 4, and in 71 patients (25%), there were ≥13. The only independent predictor for the occurrence of PNF (3.4%) or EM (5.2%) was the recipient's emergency status. During 2010 in Argentina, the liver was recovered in only half of donors. The low incidence of PNF and EM and the characteristics of the nonrecovered liver donors suggest that organ acceptance criteria should be less rigorous.
authors.affiliation: FUNDIEH (Fundación para la Docencia e Investigación de las Enfermedades del Hígado), Buenos Aires, Argentina.
authors.forename: Melisa
authors.initials: M
authors.lastname: Dirchwolf
authors.forename: Andrés E
authors.initials: AE
authors.lastname: Ruf
authors.forename: Scott W
authors.initials: SW
authors.lastname: Biggins
authors.forename: Liliana
authors.initials: L
authors.lastname: Bisigniano
authors.forename: Daniela
authors.initials: D
authors.lastname: Hansen Krogh
authors.forename: Federico G
authors.initials: FG
authors.lastname: Villamil
mesh_terms: D000328:Adult; D000368:Aged; D001118:Argentina; D046148:Donor Selection; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009927:Tissue and Organ Procurement
keywords: deceased donor liver; deceased organ donation; extended criteria liver donor; liver transplantation; rejected offers