Related Experiment Videos
Effect of donor-disseminated intravascular coagulation in liver transplantation
S S Cheng1, C W Pinson, R R Lopez
1Department of Surgery, Oregon Health Sciences University, Portland.
Insights
Disseminated intravascular coagulation (DIC) in liver donors does not negatively impact patient outcomes after liver transplantation. Recipients of livers from donors with DIC showed no significant differences in complications, graft function, or survival compared to controls.
Area of Science:
- Transplantation immunology
- Hepatology
- Coagulation disorders
Background:
- Disseminated intravascular coagulation (DIC) is common in organ donors.
- Its impact on liver transplant recipients is not well understood.
- Potential risks include impaired graft function and poorer patient outcomes.
Purpose of the Study:
- To investigate the effect of donor disseminated intravascular coagulation (DIC) on liver transplant recipient outcomes.
- To determine if DIC in donors is a valid reason to reject liver grafts.
Main Methods:
- Retrospective review of 55 liver transplantations.
- Identified 10 donors with DIC and 10 matched controls without DIC.
- Compared perioperative courses, blood product usage, liver enzyme levels, prothrombin times, hospital stay, rejection episodes, retransplantations, and mortality.
Main Results:
- No significant differences in blood product requirements between DIC and control groups.
- Similar hepatic enzyme levels and prothrombin times post-surgery.
- No statistically significant differences in hospital stay, rejection rates, retransplantations, or patient deaths.
Conclusions:
- Donor disseminated intravascular coagulation (DIC) does not adversely affect liver graft function or patient outcomes.
- DIC should not be the sole criterion for rejecting a liver for transplantation.
Abstract:
It is not known whether disseminated intravascular coagulation, present in a large percentage of organ donors, affects patient outcome after liver transplantation. We reviewed our first 55 liver transplantations and identified 10 donors with disseminated intravascular coagulation. We compared the perioperative courses of the 10 recipients of these transplanted livers with those of 10 matched controls whose donors did not have disseminated intravascular coagulation. Disseminated intravascular coagulation recipients did not require more blood products during or after surgery; their hepatic enzyme levels and prothrombin times after surgery were not statistically significantly higher than those of the controls. There was no difference in hospital stay, number of episodes of rejection, retransplantations, or deaths. The presence of disseminated intravascular coagulation in donors did not adversely affect graft function or patient outcome and should not be a sole criterion for rejecting a liver for transplantation.