Nemes Balázs, Gelley Fanni, Zádori Gergely, Görög Dénes, Fehérvári Imre, Jakab Katalin, Fazakas János, Mándli Tamás, Gerlei Zsuzsa, Sárváry Eniko, Doros Attila, Kóbori László
Semmelweis Egyetem, Altalános Orvostudományi Kar Transzplantációs és Sebészeti Klinika, Budapest.
Orv Hetil. 2009 Dec 6;150(49):2228-36. doi: 10.1556/OH.2009.28743.
Availability of suitable donor organs has always limited liver transplantations. Use of marginal donors (Extended Donor Criteria) for liver transplantation is an alternative to overcome the organ shortage. The aim of this study was to analyze the characteristics of organ donation in Hungary with special regard to marginal donors.
We reviewed data from donors and recipients between January 2003 and December 2008 retrospectively. Extended donor criteria were adopted from international recommendations.
During this period, 1078 donors were reported to the clinic. 835 (77.4%) donors were excluded from liver transplantation and 243 (22.6%) were implanted. From the 243 transplantations 40 recipients (16%) received marginal graft, 203 (84%) received non-marginal graft. Extended Donor Criteria status had no negative impact on the patient and graft survival, postoperative graft dysfunction, and other complications. Recurrence of Hepatitis C occurred earlier in those patients who received marginal graft.
There is an increasing number of patients waiting for liver transplantation in Hungary. There is no significant difference in morbidity and mortality of patients receiving marginal or non-marginal graft. Use of marginal grafts should be avoided in Hepatitis C virus positive recipients. Acceptance of older donors for liver transplantation should be considered.
合适供体器官的可获得性一直限制着肝移植手术。使用边缘供体（扩大供体标准）进行肝移植是克服器官短缺的一种替代方法。本研究的目的是分析匈牙利器官捐献的特征，特别关注边缘供体。
我们回顾性分析了2003年1月至2008年12月期间供体和受体的数据。扩大供体标准采用国际推荐标准。
在此期间，有1078名供体被报告至诊所。835名（77.4%）供体被排除在肝移植之外，243名（22.6%）供体进行了移植。在这243例移植手术中，40名受体（16%）接受了边缘供肝，203名（84%）接受了非边缘供肝。扩大供体标准状态对患者和移植物存活、术后移植物功能障碍及其他并发症没有负面影响。接受边缘供肝的患者丙型肝炎复发更早。
匈牙利等待肝移植的患者数量在增加。接受边缘或非边缘供肝的患者在发病率和死亡率方面没有显著差异。丙型肝炎病毒阳性受体应避免使用边缘供肝。应考虑接受年龄较大的供体进行肝移植。
