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Intraoperative assessment of liver organ condition by the procurement surgeon
E Domínguez Fernández1, M Schmid, F Bittinger
1Department of Visceral, Thoracic, and Vascular Surgery, Philipps University Marburg, Mainz, Germany.
Unlabelled:
Generally the transplanting surgeon accepts or declines the offer of a marginal organ in view of all available information. Hence, in some cases it is the procurement surgeon who decides about the suitability for potential further liver transplantation.
Methods:
From January 1, 2003 to September 30, 2005, a total of 402 organ procurement operations were performed in our region.
Results:
Due to infrastructural problems in nine cases intraoperative evaluation of liver biopsies was not achievable in time, and the decision to reject the organs was based on the procurement surgeon's clinical assessment. The main reason for liver rejection was alleged extreme steatosis, (6 of 9) or liver cirrhosis (3 of 9). Surprisingly, postoperative histological examinations only confirmed the clinical impression in one of nine cases.
Conclusions:
The clinical assessment of the explanting surgeon resulted in discarding eight of nine organs, potentially not contributing them to the donor pool of EUROTRANSPLANT. Further research is necessary to examine the accuracy of clinical evaluation of donor livers as well their correlation with histology.