AI Article Synopsis
- The increasing shortage of transplantable organs and aging donor populations are forcing surgeons to consider marginal organs for transplantation.
- A case study involved a 54-year-old brain-dead donor with severe atherosclerosis in the aorta, prompting careful consideration before transplanting the liver, which ultimately went ahead due to the graft's viability.
- The recipient has had a successful recovery, highlighting that severe atherosclerosis may not automatically disqualify an organ, with new preservation methods potentially improving the use of such grafts.
Article Abstract
As the scarcity of transplantable organs continues to increase, juxtaposed with an aging donor population, transplant surgeons are increasingly confronted with marginal organ offers. The presence of atherosclerosis in the donor allograft has been shown to compromise the vascular integrity and predispose to vascular complications in the transplanted liver. Here, we present a case of 54-year-old brain-dead donor who was discovered to have a severely diseased aorta during organ recovery. Pathologic evaluation revealed severe atherosclerosis with calcifications. Because there was no evidence of donor graft dysfunction, we elected to proceed with implantation, although thoughtful consideration was given to aborting the procedure. The donor hepatic artery was resected from the bifurcation of the splenic artery and the common hepatic artery until no further gross atheromas were evident; this segment was then anastomosed with the recipient proper hepatic artery. The recipient is doing well 6 months after transplant without any significant adverse postoperative events. The presence of severe atherosclerosis should not discourage the use of an otherwise adequate graft. Novel newer preservation techniques, such as normothermic perfusion, may enable functional graft evaluation and can increase the utilization of marginal grafts.
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| http://dx.doi.org/10.6002/ect.2017.0229 | DOI Listing |
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