A comparison of two questionnaires on Informed Consent for extended criteria liver donors

A questionnaire concerning informed recipient's consent for "extended criteria liver donors"(ECD), after approval of the Institutional Review Board(IRB), was sent in different times by e-mail to members of 2 scientific societies, ELPAT (Ethical,Legal and Psychologic Aspects of Organ Transplantation) and ELITA (European Liver and Intestine Transplant Association)-ELTR(European Liver Transplant Registry.

The results were published in different papers in Transplantation Proceedings.

By comparing tables in the 2011 ELPAT and 2013 ELITA papers, in the most recent paper less Liver Transplant Centers(LTC) considered age as high as 80 years (p<.002)and SGOT>90 IU (p<.02), or all criteria together (p<.0001), as indicators of ECD.

This may reflects the fact that more recently LTC have become less selective, due to the rising mortality in the increasing liver transplant waiting list. In all these studies we highlighted both a disparity of practice across centres and the relatively large contribution made by ECD livers to the transplantation effort.

Therefore patients should receive all the required informations concerning the quality of the liver offered to them for transplantation, not only when they are enlisted, but also when the liver becomes available and is proposed to them. It is also possible to create a special waiting list of patients not accepting ECD, although this option could delay liver transplantation and consequently increase mortality.