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Nephrology Dialysis Transplantation 2007 22(Supplement 8):viii29-viii36; doi:10.1093/ndt/gfm654
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Utilization of extended donor criteria in liver transplantation: a comprehensive review of the literature

Arash Nickkholgh1, Jürgen Weitz1, Jens Encke2, Peter Sauer2, Arianeb Mehrabi1, Markus W. Büchler1, Jan Schmidt1 and Peter Schemmer1

1Department of General Surgery and 2Department of Gastroenterology, Ruprecht-Karls-University, Heidelberg, Germany

Correspondence to: Prof. Dr. Peter Schemmer, Dept. of General Surgery, Ruprecht-Karls-University, INF 110, 69120 Heidelberg, Germany. Email: Peter_Schemmer{at}med.uni-heidelberg.de



  Abstract

Organ shortage has driven many transplant programs to extend their criteria to accept donors. The goal of the present work is to further characterize the most important extended donor criteria (EDC) in liver transplantation and to identify factors that impact outcomes for this type of grafts through a comprehensive review of the most recent findings and current opinions. Age, steatosis, positive viral hepatitis serology, intensive care unit stay, and history of malignancy in donor have been the matter of substantial debate in recent years and are therefore discussed in further detail here. Cold and warm ischemic times have also been discussed separately as they have been identified as important independent risk factors for mortality. The use of grafts with EDC provides an immediate expansion of the donor pool. However, in order to optimize effective utilization of EDC, attempts should be made to carefully match the most appropriate graft-recipient pair.

Keywords: liver transplantation; extended donor criteria; graft survival; patient survival; donor age; steatosis; hepatitis; malignancy; ischemia time


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