Liver transplantation using donor organs with markedly elevated liver enzymes

StephenW

<http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02525.x/abstract>

Liver transplantation using donor organs with markedly elevated liver
enzymes: how far can we go?

Sonia Radunz, Andreas Paul, Knut Nowak, Jürgen W. Treckmann, Fuat H.
Saner, Zoltan MathéArticle first published online: 5 APR 2011

DOI: 10.1111/j.1478-3231.2011.02525.x
© 2011 John Wiley & Sons A/S
Issue

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.



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lin12345

肝移植使用的器官肝脏明显升高
酵素：我们走多远？

索尼娅Radunz，安德烈亚斯保罗，克努特诺瓦克，于尔根瓦特Treckmann，Fuat阁下
萨纳，佐尔坦MathéArticle首次发表时间：2011年4月5日

分类号：10.1111/j.1478-3231.2011.02525.x
© 2011年约翰Wiley＆Sons出版A / S公司
发行

国际肝病
早期查看（网络版日前发表记录列入一
问题）

摘要

背景：固体机关之间的需求和差距
目前的供应是一个病人越来越多的终末期肝病的问题
疾病。为了克服器官短缺，扩展准则捐赠者的器官
同时接受肝移植。

目的：我们在这里空前的患者报告的临床过程
接受肝酶明显升高与肝脏。

方法：2007年11月至2010年12月15日与供肝
肝酶明显升高[中位数谷草转氨酶（AST）
1400（500-7538）美国/升，中谷丙转氨酶（ALT）1026
（308-9179）单位/ L]均提供给我们的移植中心。基于详细
判断，这些被拒绝的供肝七，八供肝
移植。

结果：八移植患者显示对肝脏酶高峰
一天手术（2076 ± 1808助攻单位/升，谷丙转氨酶1087 ± 833单位/ L）和统计学
从第一天开始显着下降0到7天后肝移植。印度卢比
减少，血小板计数显着增加在1统计学
一周后肝移植。患者出院从
28 ± 11天医院后良好的临床肝移植
条件。

结论：这些数据表明，与使用供肝显着
肝酶升高可能是可以接受的办法来扩大捐助
池。验收的普遍目标的参数应该被定义在
未来的研究。