Abstract
liver Transplantation is currently the treatment of choice for several terminal liver diseases. Despite the increase in performed transplants, the waiting lists continue to increase. In order to expand the supply of organs, transplantation teams have started to use previously rejected livers for transplants because of an increased risk of unfavorable outcomes. to evaluate the use of livers of expanded criterion donators. retrospective study of medical records. The livers were classified as normal or expanded criteria. The groups were divided in low and high MELD. A multivariate analysis was performed through logistic regression. there was no statistical difference regarding early, late and global mortality between the groups. Decreased survival was observed in patients with high MELD (higher or equal to 20) when they received grafts from expanded criterion donators. The association between the occurrence of cardiorespiratory arrest and presence of elevated total bilirubin in donators was associated with higher mortality rates in expanded criterion livers. the overall results are similar, but expanded criteria liver donators was associated with higher mortality in patients with high MELD.
Highlights
Orthotopic liver transplantation (OLT) has developed in recent decades and is currently the treatment of choice for terminal liver diseases[1]
In agreement with these data, we observed that 50.9% (56 cases) of the grafts used for transplantation during the study period were from expanded criteria donors (ECD), which contributed to a significant increase in the number of transplants performed in this period due to the expansion of the liver grafts’ acceptance criteria
As for the MELD within each group, we found a slight difference in the groups with high MELD (≥ 20), especially in the ECD group
Summary
Orthotopic liver transplantation (OLT) has developed in recent decades and is currently the treatment of choice for terminal liver diseases[1]. New perspectives have emerged for the management of patients with advanced liver diseases, making these procedures routine in several centers. With better results and definitions of criteria and indications for OLT, a new obstacle arises: the disproportion between patients on the waiting list and organs supply. In Brazil, liver transplantation is regulated by the Ministry of Health Ordinance No 2,600, of October 21, 2009, with the objective of updating, perfecting, and standardizing the operation of the National Transplant System, determining which indications and situations characterize priority[3]. Serum dosages of total bilirubin, creatinine, and international standardized ratio of prothrombin activity (INR) are used to calculate MELD, and serum dosages of total bilirubin, albumin, and INR, to compute PELD4. In 2019, sodium was included as a criterion for calculating MELD-Na
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
