Mazaheri Masoud, Mojtabaee Meysam, Mohsenzadeh Mojtaba, Shahryari Shagin, Sadegh Beigee Farahnaz
From the Organ Procurement Unit (OPU), Lung Transplantation Research Center (LTRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
Exp Clin Transplant. 2019 Jan;17(Suppl 1):254-256. doi: 10.6002/ect.MESOT2018.P112.
Livers from deceased donors compose nearly 30% of all organ transplants, and about 700 liver transplants are carried out per year. Marginal livers (extended-criteria donors), however, are not usually accepted by recipient teams, and there is only one center for these procedures in Iran. The final decision is made according to criteria that are much more conservative than other globally accepted ones.
To find significant differences and construct an algorithm to predict the future of marginal livers (before transfer of donors to our organ procurement unit), successfully donated and unsuccessfully donated livers divided into 2 age groups were compared in terms of age, sex, body mass index, liver function tests, significant medical disorders, and preretrieval liver sonography report.
In the first age group (50-59 years old), there were 88 successful donors and 27 unsuccessful cases (due to 3 reasons: positive virology tests, death before retrieval, and ruled out by surgeons in the operating room). In the second age group (? 60 years old), there were 45 successful donors and 11 unsuccessful cases. The results showed that there were no differences between successful and unsuccessful cases regarding age and liver sonography results; however, sex, body mass index, liver function tests, and previous medical disorder were different between groups. Donors in both age groups were mostly male (60% and 73%); however, surprisingly, most unsuccessful cases were female (56.6% and 57%). Donors had generally lower body mass index (2 numerical difference), better liver function tests, and less risk factors (heart disease, diabetes mellitus, fatty liver, and chronic alcohol consumption).
Before transfer of marginal liver donors to the organ procurement unit for further evaluation and organ retrieval, one must consider that age is just a number and the presence of other comorbidities can have more decisive roles on liver quality.
来自已故捐赠者的肝脏占所有器官移植的近30%，每年约进行700例肝脏移植。然而，边缘性肝脏（扩展标准捐赠者）通常不被受者团队接受，在伊朗只有一个中心进行这些手术。最终决定是根据比其他全球公认标准更为保守的标准做出的。
为了找出显著差异并构建一种算法来预测边缘性肝脏的未来（在捐赠者转至我们的器官获取单位之前），将成功捐赠和未成功捐赠的肝脏分为两个年龄组，比较其年龄、性别、体重指数、肝功能检查、重大疾病以及获取前肝脏超声报告。
在第一年龄组（50 - 59岁），有88例成功捐赠者和27例未成功案例（原因有3个：病毒学检测呈阳性、获取前死亡以及在手术室被外科医生排除）。在第二年龄组（≥60岁），有45例成功捐赠者和11例未成功案例。结果表明，成功和未成功案例在年龄和肝脏超声结果方面无差异；然而，两组在性别、体重指数、肝功能检查以及既往疾病方面存在差异。两个年龄组的捐赠者大多为男性（分别为60%和73%）；然而，令人惊讶的是，大多数未成功案例为女性（分别为56.6%和57%）。捐赠者的体重指数普遍较低（相差2个数值），肝功能检查较好，且危险因素（心脏病、糖尿病、脂肪肝和长期饮酒）较少。
在将边缘性肝脏捐赠者转至器官获取单位进行进一步评估和器官获取之前，必须考虑到年龄只是一个数字，其他合并症的存在对肝脏质量可能具有更决定性的作用。
