title: Lacerated Liver Graft in an Open Abdomen Setting: A Case Report.
abstract: Donor scarcity is a primary problem in the development of a transplant program. The imbalance between an extremely increasing demand and the number of organs in the supply has led to an extended criteria donor approach. The successful use of donors with infectious diseases and septic shock has been reported. However, organs from deceased donors with traumatic abdominal injury and open abdomen are usually discarded due to risks of severe infections. Thus far, only 1 such case, in which a liver graft from an open abdomen was used successfully, has been reported. Herein, we report of a case of liver transplant using a traumatized liver allograft procured from a deceased donor with an open abdomen. The donor was a 16-year-old patient who had blunt abdominal trauma and severe head injury from a car accident, resulting in emergency laparotomy with suturing of the lacerated wound at the liver and abdominal packing. The donor was subsequently pronounced brain dead, and the family consented to organ donation. A multiorgan procurement was performed, and the liver was transplanted to 52-year-old patient who had multiple hepatocellular carcinomas. The postoperative course was without any infection or rejection. In conclusion, the use of donor livers with preexisting trauma in open abdomen settings can be used as alternative to expand the organ donor pool.
authors.affiliation: From the Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Sunhawit
authors.initials: S
authors.lastname: Junrungsee
authors.forename: Krongporn
authors.initials: K
authors.lastname: Ongprasert
authors.forename: Wasana
authors.initials: W
authors.lastname: Ko-Iam
authors.forename: Worakitti
authors.initials: W
authors.lastname: Lapisatepun
authors.forename: Tidarat
authors.initials: T
authors.lastname: Jirapongcharoenlap
authors.forename: Settapong
authors.initials: S
authors.lastname: Boonsri
authors.forename: Suraphong
authors.initials: S
authors.lastname: Lorsomradee
authors.forename: Anon
authors.initials: A
authors.lastname: Chotirosniramit
authors.forename: Trichak
authors.initials: T
authors.lastname: Sandhu
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis / Q000209:etiology*; D000063:Accidents, Traffic; D000293:Adolescent; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery* / Q000821:virology; D002423:Cause of Death; D046148:Donor Selection; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000821:virology; D006801:Humans; D008099:Liver / Q000293:injuries* / Q000601:surgery*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000209:etiology*