Extended criteria brain-dead organ donors:Prevalence and impact on the utilisation of livers for transplantation in Brazil  

作　　者：Victoria S Braga Amanda P C S Boteon Heloisa B Paglione Rafael A A Pecora Yuri L Boteon 

机构地区：[1]Faculdade Israelita de Ciências da Saúde Albert Einstein,Hospital Israelita Albert Einstein,São Paulo 05652-900,Brazil [2]Transplant Centre,Hospital Israelita Albert Einstein,São Paulo 05652-900,Brazil

出　　处：《World Journal of Hepatology》2023年第2期255-264,共10页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Despite its association with higher postoperative morbidity and mortality,the use of extended criteria donor(ECD)livers for transplantation has increased globally due to the high demand for the procedure.AIM To investigate the prevalence of ECD in donation after brain death(DBD)and its impact on organ acceptance for transplantation.METHODS Retrospective analysis of DBD organ offers for liver transplantation between 2017 and 2020 in a high-volume transplant centre.The incidence of the Eurotransplant risk factors to define an ECD(ET-ECD)among DBD donors and the likelihood of organ acceptance over the years were analysed.The relationship between organ refusal for transplantation,the occurrence,and the number of ET-ECD was assessed by simple and multiple logistic regression adjustment.RESULTS A total of 1619 organ donors were evaluated.Of these,78.31%(n=1268)had at least one ET-ECD criterion.There was an increase in the acceptance of ECD DBD organs for transplantation(1 criterion:from 23.40%to 31.60%;2 criteria:from 13.10%to 27.70%;3 criteria:From 6.30%to 13.60%).For each addition of one ETECD variable,the estimated chance of organ refusal was 64.4%higher(OR 1.644,95%CI 1.469-1.839,P<0.001).Except for the donor serum sodium>165 mmol/L(P=0.310),all ET-ECD criteria increased the estimated chance of organ refusal for transplantation.CONCLUSION A high prevalence of ECD DBD was observed.Despite the increase in their utilisation,the presence and the number of extended donor criteria were associated with an increased likelihood of their refusal for transplantation.

关 键 词：Liver transplantation Extended criteria donors Donation after brain death Organ donation 

分 类 号：R575[医药卫生—消化系统]