Anencephalics: a potential source of donor livers

Abstract

Paediatric liver transplantation for small infants is limited by donor availability. This study investigates whether anencephalic babies might be potential neonatal liver donors. We reviewed 174 cases of anencephalic babies born (1970–1987) in the National Maternity Hospital, Dublin. Out of a total number of 69 (40%) live births, 27 were term or older, and of these 22 weighed >-2.5 kg. This group of 22 probably represent the most suitable “potential donors” (13% of total): only 4 had associated serious anomalies (4 renal, 1 cardiac). There were no hepatic anomalies. The mean duration of life was 37 h (median 28 h) in the study group compared to 1.5 h (median 30 min) in the remainder of the anencephalic population. Liver weights fell within 20% of the predicted range. Liver histology was re-examined to assess maturity, extramedulary haematopoiesis, and any biliary pathology; when compared with a control group of neonates there was no statistical difference. From this study it appears that physically and structurally these livers may be suitable for transplantation.