title: Liver transplantation utilizing a severely fractured graft: every organ counts.
abstract: In our current era where shortage of liver grafts is commonplace, utilization of traumatic liver grafts may represent an opportunity to expand the organ donor pool without compromising graft survival. However, data on liver transplantation using a fractured liver allograft is scarce, with only small case series and reports found in the literature. In this report, we describe our experience with utilizing a liver graft with grade IV hepatic fracture for transplantation. At 12 months follow up, the recipient has excellent graft function and has regained an excellent quality of life. We demonstrated that the ability to safely use a fractured liver graft represents an additional avenue for expansion of the deceased donor population, especially in regions with prolonged waitlist times.
authors.affiliation: Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Zhi Ven
authors.initials: ZV
authors.lastname: Fong
authors.affiliation: Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Madhukar S
authors.initials: MS
authors.lastname: Patel
authors.affiliation: Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Yeh
authors.affiliation: Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Markmann
authors.affiliation: Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Parsia A
authors.initials: PA
authors.lastname: Vagefi
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D046148:Donor Selection; D017809:Fatal Outcome; D005260:Female; D006085:Graft Survival; D006323:Heart Arrest / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D015601:Injury Severity Score; D008099:Liver / Q000293:injuries*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000175:diagnosis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome