Assessment of Cadaveric Livers Discarded from Transplantation. A Correlation Between Clinical and Histological Parameters
Jaroslaw Czerwinski, Agnieszka Perkowska, Andrzej Mroz, Beata Lagiewska, Leszek Adadynski, Magdalena Durlik, Maciej Glyda, Wojciech Lisik, Marek Pacholczyk, Leszek Paczek, Wojciech Polak, Zbigniew Sledzinski, Dariusz Wasiak, Zbigniew Wlodarczyk, Janusz Walaszewski, Piotr Malkowski, Andrzej Chmura, Wojciech Rowinski
Ann Transplant 2007; 12(2): 30-36
Background: We designed a study with the following aims: to assess tissue quality of 100 cadaveric livers discarded from transplantation, to identify discarded organs which could have been used either for transplantation or for isolation of hepatocytes, to assess donor clinical factors which may impact the histology.
Material/Methods: Liver wedge biopsies were performed during kidney procurement, sent for processing and data interpretation.
Results: In 46% of the evaluated tissues severe changes were found; these organs according to pathologists were “not suitable for transplantation”. In 19% less pronounced changes classified organs as “probably not suitable for transplantation”. In 35% biopsies only minimal changes were found; these organs were classified as “probably suitable for transplantation” and could have been harvested as marginal organs or at least used for hepatocytes isolation.
Conclusions: Results of biopsies suggested that approximately in one third of livers discarded from transplantation due to clinical donor parameters could have been harvested from histological point of view. Several donor clinical risk factors (alcohol addiction, hyperbilirubinemia, increased transaminase activity) correlate with severe histological changes rending the liver “not suitable for transplantation”.
Keywords: Liver Transplantation, donor criteria, liver histology