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. 2021 Sep;35(9):e14419.
doi: 10.1111/ctr.14419. Epub 2021 Sep 16.

The use of organ donor blood in liver transplantation

Gia Toan Tang  1 , Ruth Shaylor  2 , Victor Hui  2 , Greg Przybylowski  1 , Robert McLaren Jones  1   3 , Graham Starkey  1 , Marcos Vinicius Perini  1   3 , Bao-Zhong Wang  1   3 , Daniela Zantomio  4 , Chris Hogan  4 , Michael Anthony Fink  1   3
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The use of organ donor blood in liver transplantation

Gia Toan Tang et al. Clin Transplant. 2021 Sep.

Abstract

Background: Blood removed from organs during deceased donor organ procurement is routinely discarded but is a potential resource for donor-specific transfusion (DST) in subsequent liver transplantation (LT). This study retrospectively analyses the impact of DST on intraoperative bank blood product usage, long-term graft, and patient survival, as well as frequency of rejection post-LT.

Methods: A total of 992 adult LT performed from 1993 to 2018 in a single quaternary center were included. Intraoperative blood product usage, patient, and graft survival, as well as acute and chronic rejection were assessed in patients who received blood retrieved from the organ donor, the "donor blood" (DB) group (n = 437) and patients who did not, the "no donor blood" (NDB) group (n = 555).

Results: Processing of DB ensured safe levels of potassium, magnesium, and insulin. There were fewer units of bank red blood cells transfusion required in the DB group compared to NDB group (2 vs. 4 units, P = .01). Graft survival was significantly superior in the DB group (10-year survival 75% vs. 69%, respectively, P = .04) but DST was not an independent predictor of graft survival. There was no significant difference in patient survival or rejection between the groups. There was no difference in treated, biopsy-proven rejection between the two groups.

Conclusions: This is the first large-cohort study assessing long-term outcomes of intraoperative DST in LT. The collection of organ donor blood and subsequent use in LT recipients appeared feasible with appropriate quality checks ensuring safety. DST resulted in a reduction in the use of packed red blood cells. There was no difference in the rate of rejection or graft or patient survival.

Keywords: blood donors; blood transfusion; donor-specific transfusion; immunology; tissue and organ procurement.

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References

REFERENCES

    1. Clevenger B, Mallett SV. Transfusion and coagulation management in liver transplantation. World J Gastroenterol. 2014;20(20):6146-6158.
    1. Fabbroni D, Bellamy M. Anaesthesia for hepatic transplantation. Continuing Educ Anaesthesia Crit Care Pain. 2006;6(5):171-175.
    1. Salvatierra O Jr., Vincenti F, Amend W, et al. Deliberate donor-specific blood transfusions prior to living related renal transplantation. A new approach. Ann Surg. 1980;192(4):543-552.
    1. Sollinger HW, Kalayoglu M, Belzer FO. Use of the donor specific transfusion protocol in living-unrelated donor-recipient combinations. Ann Surg. 1986;204(3):315-321.
    1. Katsumori T, Yamaguchi Y, Mori K, et al. The time course of cell-mediated lympholysis in rat hepatic allograft recipients pretreated with a single donor-specific blood transfusion. Transplantation. 1992;54(3):531-536.

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