Liver International
Early View (Online Version of Record published before inclusion in an
issue)
Abstract
Background: The disparity between the demand for solid organs and the
current supply is a growing problem for patients with end-stage liver
disease. To overcome organ shortage, extended criteria donor organs are
also accepted for liver transplantation.
Aims: We here unprecedentedly report the clinical course of patients
receiving livers with markedly elevated liver enzymes.
Methods: Between November 2007 and December 2010, 15 donor livers with
markedly elevated liver enzymes [median aspartate aminotransferase (AST)
1400 (500–7538) U/l, median alanine aminotransferase (ALT) 1026
(308–9179) U/l] were offered to our transplant centre. Based on elaborate
judgment, seven of these donor livers were rejected and eight donor livers
were transplanted.
Results: All eight transplanted patients showed a liver enzyme peak on the
day of surgery (AST 2076±1808 U/l, ALT 1087±833 U/l) and a statistically
significant decrease from day 0 to day 7 post-liver transplantation. INR
decreased and platelet count increased statistically significantly within 1
week after liver transplantation. The patients were discharged from the
hospital 28±11 days after liver transplantation in good clinical
condition.
Conclusions: These data demonstrate that using donor livers with markedly
elevated liver enzymes may be an acceptable option to expand the donor
pool. Universal objective parameters for acceptance should be defined in
future studies.