Abstract:
:Donor organ shortage continues to limit the availability of liver transplantation, a successful and established therapy of end-stage liver diseases. Strategies to mitigate graft shortage include the utilization of marginal livers and recently ex-situ normothermic machine perfusion devices. A 59-year-old woman with cirrhosis due to primary sclerosing cholangitis was offered an ex-situ machine perfused graft with unnoticed severe injury of the suprahepatic vasculature due to road traffic accident. Following a complex avulsion, repair and reconstruction of all donor hepatic veins as well as the suprahepatic inferior vena cava, the patient underwent a face-to-face piggy-back orthotopic liver transplantation and was discharged on the 11th postoperative day after an uncomplicated recovery. This report illustrates the operative technique to utilize an otherwise unusable organ, in the current environment of donor shortage and declining graft quality. Normothermic machine perfusion can definitely play a role in increasing the graft pool, without compromising the quality of livers who had vascular or other damage before being ex-situ perfused. Furthermore, it emphasizes the importance of promptly and thoroughly communicating organ injuries, as well as considering all reconstructive options within the level of expertise at the recipient center.
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Athanasopoulos PG,Hadjittofi C,Dharmapala AD,Orti-Rodriguez RJ,Ferro A,Nasralla D,Konstantinidou SK,Malagó Mdoi
10.1097/MD.0000000000003119subject
Has Abstractpub_date
2016-04-01 00:00:00pages
e3119issue
15eissn
0025-7974issn
1536-5964pii
00005792-201604120-00013journal_volume
95pub_type
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