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J Surg Res. 2015 Jul;197(1):183-90. doi: 10.1016/j.jss.2015.03.093. Epub 2015 Apr 7.

A rapid, reproducible, noninvasive predictor of liver graft survival.

Author information

1
Dumont-UCLA Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California. Electronic address: azarrinpar@mednet.ucla.edu.
2
Dumont-UCLA Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.

Abstract

BACKGROUND:

Clinical and laboratory criteria are not reliable predictors of deceased donor liver graft quality. Intraoperative assessment of experienced surgeons is the gold standard. Standardizing and quantifying this assessment is especially needed now that regional sharing is the rule. We prospectively evaluated a novel, simple, rapid, noninvasive, quantitative measure of liver function performed before graft procurement.

MATERIALS AND METHODS:

Using a portable, finger-probe-based device, indocyanine green plasma disappearance rates (ICG-PDR) were measured in adult brain-dead donors in the local donor service area before organ procurement. Results were compared with graft function and outcomes. Both donor and recipient teams were blinded to ICG-PDR measurements.

RESULTS:

Measurements were performed on 53 consecutive donors. Eleven liver grafts were declined by all centers because of quality; the other 42 grafts were transplanted. Logistic regression analysis showed ICG-PDR to be the only donor variable to be significantly associated with 7-d graft survival. Donor risk index, donor age, and transaminase levels at peak or procurement were not significantly associated with 7-d graft survival.

CONCLUSIONS:

We report the successful use of a portable quantitative means of measuring liver function and its association with graft survival. These data warrant further exploration in a variety of settings to evaluate acceptable values for donated liver grafts.

KEYWORDS:

Deceased donor; Indocyanine green; Liver graft assessment; Liver graft utilization; Organ procurement

PMID:
25940156
PMCID:
PMC5025251
DOI:
10.1016/j.jss.2015.03.093
[Indexed for MEDLINE]
Free PMC Article

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