Prevalence and Profile of Discarded Liver Donors in a Tertiary Health Service in Brazil From 2015 to 2018
Little has changed in donor management and liver utilization rates in Brazil over the last decade. With a growing demand for liver donations, organ waste is an important obstacle toward better patient care. The study of discarded donors helps to shed light on the possibilities of increasing organ us...
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| Published in: | Transplantation proceedings 2020-06, Vol.52 (5), p.1251-1255 |
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| Main Authors: | , , |
| Format: | Article |
| Language: | eng |
| Online Access: | Get full text |
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| Summary: | Little has changed in donor management and liver utilization rates in Brazil over the last decade. With a growing demand for liver donations, organ waste is an important obstacle toward better patient care. The study of discarded donors helps to shed light on the possibilities of increasing organ usage, including by using extended criteria donors.
We retrospectively analyzed all discarded liver donors in a high-volume Brazilian transplant center from January 2015 to December 2018. Pertinent clinical and laboratorial data were collected from the donors’ electronic health records.
In our study period, there were 248 liver harvests, of which 67 (27.0%) were discarded. Most discarded donors were male (65.7%). More than three-quarters of donors were Caucasian (79.1%). Median donor body mass index was 26.27 kg/m2, and most discarded donors presented no comorbidities. Donor liver injury tests were abnormal in 56 (83.5%) out of 67 discarded donors. Forty-three (64.1%) donors presented elevated transaminases. Alanine aminotransferase levels were elevated in 35 (52.2%) discarded donors, with a median value of 38 U/L. Half of all discarded livers were due to graft-related issues. Twenty-eight organs (41.79%) presented external pathologic alterations. Organ refusal due to donor clinical and laboratorial condition was reported in 24 cases.
It is clear there is a considerable issue of organ waste in Brazil, with the subjective judgment of graft quality and inadequate interpretation of donor’s laboratorial exams leading to excessive denial of organs that could be fitted into extended criteria for donation.
•Current organ waste and discarded donor epidemiological parameters in Brazil are comparable to findings displayed in international literature.•Most liver denials are related to the organ’s subjective pathological appearance rather than objective data.•Although most discarded donors presented altered liver function tests, there is still potential of increasing donor pool by adopting broader donor selection criteria. |
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| ISSN: | 0041-1345 1873-2623 |