Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Dec 31;11(1):215.
doi: 10.3390/jcm11010215.

An Update on Usage of High-Risk Donors in Liver Transplantation

Affiliations
Review

An Update on Usage of High-Risk Donors in Liver Transplantation

Haris Muhammad et al. J Clin Med. .

Abstract

The ideal management for end stage liver disease, acute liver failure, and hepatocellular carcinoma (HCC), within specific criteria, is liver transplantation (LT). Over the years, there has been a steady increase in the candidates listed for LT, without a corresponding increase in the donor pool. Therefore, due to organ shortage, it has been substantially difficult to reduce waitlist mortality among patients awaiting LT. Thus, marginal donors such as elderly donors, steatotic donors, split liver, and donors after cardiac death (DCD), which were once not commonly used, are now considered. Furthermore, it is encouraging to see the passing of Acts, such as the HIV Organ Policy Equity (HOPE) Act, enabling further research and development in utilizing HIV grafts. Subsequently, the newer antivirals have aided in successful post-transplant period, especially for hepatitis C positive grafts. However, currently, there is no standardization, and protocols are center specific in the usage of marginal donors. Therefore, studies with longer follow ups are required to standardize its use.

Keywords: HIV Organ Policy Equity (HOPE) Act; donors after cardiac death; liver transplantation; split liver; steatotic donors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Starzl T.E., Marchioro T.L., Von Kaulla K.N., Hermann G., Brittain R.S., Waddell W.R. Homotransplantation of the Liver in Humans. Surgery Gynecol. Obstet. 1963;117:659–676. - PMC - PubMed
    1. Kwong A.J., Kim W.R., Lake J.R., Smith J.M., Schladt D.P., Skeans M.A., Noreen S.M., Foutz J., Booker S.E., Cafarella M., et al. OPTN/SRTR 2019 Annual Data Report: Liver. Am. J. Transplant. 2021;21((Suppl. 2)):208–315. doi: 10.1111/ajt.16494. - DOI - PubMed
    1. Pavicevic S., Uluk D., Reichelt S., Fikatas P., Globke B., Raschzok N., Schmelzle M., Öllinger R., Schöning W., Eurich D., et al. Hypothermic oxygenated machine perfusion for extended criteria donor allografts-Preliminary experience with extended organ preservation times in the setting of organ reallocation. Artif. Organs. 2021 doi: 10.1111/aor.14103. - DOI - PubMed
    1. Roland M.E., Barin B., Carlson L., Frassetto L.A., Terrault N.A., Hirose R., Freise C.E., Benet L.Z., Ascher N.L., Roberts J.P., et al. HIV-infected liver and kidney transplant recipients: 1- and 3-year outcomes. Am. J. Transplant. 2008;8:355–365. doi: 10.1111/j.1600-6143.2007.02061.x. - DOI - PubMed
    1. Sawinski D., Goldberg D.S., Blumberg E., Abt P.L., Bloom R.D., Forde K.A. Beyond the NIH Multicenter HIV Transplant Trial Experience: Outcomes of HIV+ Liver Transplant Recipients Compared to HCV+ or HIV+/HCV+ Coinfected Recipients in the United States. Clin. Infect. Dis. 2015;61:1054–1062. doi: 10.1093/cid/civ471. - DOI - PMC - PubMed

LinkOut - more resources