A preliminary European study on extended-criteria liver donation and transplant recipient consent

ELPAT (Ethical, Legal, and Psychologic Aspects of Organ Transplantation) coordinated the distribution to European liver transplant centers of an electronic questionnaire regarding the definition of extended-criteria liver donation (ECD) and its implication for informed consent by transplant recipients. Completed questionnaires were received from 30 centers in 13 countries including 28 who accepted ECD liver donors. The criteria to define a liver donor as ECD were: steatosis in 24 centers (85%); age up to 80 years in 23 centers (82%); serum sodium >165 mmol/L in 17 centers (60%); ICU stay with ventilation >7 days in 16 centers (57%); serum glutamic oxaloacetic transaminas >90 U/L, in 12 centres (42%); body mass index >30 kg/m(2) in 10 centers (35%); serum glutamate pyruvate transaminase >105 U/L in 10 centers (35%); serum bilirubin >3 mg/dL in 10 centers (35%); and other criteria in 13 centers (46%). Twenty-three centers informed the transplant candidate of the ECD status of the donor: 10 (43%) when the patient registered for transplantation, 3 (14%) when an ECD liver became available, and 10 (43%) on both occasions. Ten centers required the liver transplant candidate to sign a special consent form. Ten centers informed the potential recipient of the donor's serology. Only 3 centers informed the potential recipient of any high-risk behavior of the donor.