Livers from brain dead donors with chronic active alcohol abuse for liver transplantation

Abstract

Background: Liver grafts from donors with chronic and active history of alcohol abuse are usually discarded for liver transplantation (LT). Our aim is to report our results with those grafts. Methods: We performed a case control study on 113 LT from 2015 to 2016. Inclusion criteria for the study group were adult patients transplanted with livers from donors with chronic active alcohol abuse. The control group consisted in randomly matched LTs with similar recipient (R) and donor (D) age, sex and ischemia time, performed in those two years with standard livers. The ratio of case-to-control was 1:2. Short term results, biochemical data from day 0 to 30 after LT, complications and survival are reported. Data were compared. P≤0.5 was considered statistically significant. Results: The study group consisted of 4 LT whereas 8 patients transplanted with standard grafts served as control group. Mean micro-macro steatosis percentage in livers from donors with alcohol abuse was 36±16%. Laboratory exams showed statistically significant worse values for Aspartate Aminotransferase and International Normalized Ratio at Day 0, and Total Bilirubin at day 8, for livers from donors with alcohol abuse. No statistical difference was found in the occurrence of rejection episodes. All patients of both groups are alive after 347±264 days (range 24-725) from LT. Conclusion: May be it’s time to reconsider the use for LT of livers from donors with chronic and active alcohol abuse.