Comparison of Two Questionnaires on Informed Consent in "Marginal" Donor Liver

Area of Science:

• Hepatology
• Transplantation Medicine
• Organ Donation

Background:

• The increasing need for liver donors necessitates a re-evaluation of traditional organ acceptance criteria.
• Expanded criteria donation (ECD) and marginal/high-risk organ donors are being considered to broaden the donor pool.

Purpose of the Study:

• To assess European liver transplant centers' perspectives on current and proposed extended donor and recipient criteria for liver transplantation.
• To identify areas of consensus and disagreement regarding the acceptance of marginal organs.

Main Methods:

• A questionnaire was distributed to 53 European liver transplant centers, coordinated by ELPAT, ELITA, and ELTR.
• Responses were analyzed to categorize donor and recipient criteria based on acceptance rates.

Main Results:

• Criteria like steatosis, serum sodium >165 mmol/L, and recipient cancer history were not contraindications in over 60% of cases.
• ICU stay, BMI >30, high bilirubin, and critical illness were deemed inadequate for transplantation by 30-59% of centers.
• No consensus was reached on criteria such as donor age up to 80, specific enzyme levels, high-risk behaviors, or recipient age groups.

Conclusions:

• Significant variation exists among European centers regarding the acceptance of extended criteria for liver donors and recipients.
• Further multicenter studies are required to establish definitive guidelines for ECD and marginal organ utilization in liver transplantation.