| Veröffentlichte Version Download ( PDF | 889kB) | Lizenz: Creative Commons Namensnennung 4.0 International |
Optimization of surgical evaluation algorithms for living donor liver transplantation
Kupke, Paul
, Schropp, Verena, Schurr, Leonhard A.
, Dropco, Ivor
, Kupke, Laura S., Götz, Markus, Geissler, Edward K.
, Schlitt, Hans J.
und Werner, Jens M.
(2024)
Optimization of surgical evaluation algorithms for living donor liver transplantation.
Digestive and Liver Disease 57 (3), S. 724-729.
Veröffentlichungsdatum dieses Volltextes: 27 Feb 2025 05:43
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.75084
Zusammenfassung
Background Living donor liver transplantation (LDLT) is an established and endorsed alternative for deceased donor liver transplantation with better recipient outcomes. Nevertheless, while extensive evaluation of potential donors is crucial, evaluation algorithms differ between transplant centres and guidelines. Methods We included 317 individuals evaluated for LDLT between 07/2007–07/2022 in ...
Background
Living donor liver transplantation (LDLT) is an established and endorsed alternative for deceased donor liver transplantation with better recipient outcomes. Nevertheless, while extensive evaluation of potential donors is crucial, evaluation algorithms differ between transplant centres and guidelines.
Methods
We included 317 individuals evaluated for LDLT between 07/2007–07/2022 in a retrospective analysis. The evaluation process was analysed to identify the key reasons for declining 77 potential donors. Additionally, 146 donors that underwent LDLT were analysed regarding risk factors for complications.
Results
The main reasons for donor refusal were liver volumetry (40.3 %) and metabolic factors including obesity or steatotic liver disease (20.8 %). Contrast-enhanced computed tomography (CECT) identified 63.6 % of all declined donors; CECT combined with assessment of medical history, physical examination, blood testing and ultrasonography, identified 87.0 % of declined potential donors. Associated with this selection, complication rates in donors were low (≥II in 17.1 %; none with ≥IVb). Notably, higher age was a risk factor for developing a complication ≥II after hemi-hepatectomy (p = 0.0373).
Conclusions
We propose a progressive 4-step evaluation algorithm that begins with a very basic assessment combined with up-front CECT. This early phase of testing is expected to identify nearly 90 % of ineligible donors, thereby conserving critical resources, time and money, as well as minimising burden for potential donors.
Alternative Links zum Volltext
Beteiligte Einrichtungen
Details
| Dokumentenart | Artikel | ||||
| Titel eines Journals oder einer Zeitschrift | Digestive and Liver Disease | ||||
| Verlag: | Elsevier | ||||
|---|---|---|---|---|---|
| Band: | 57 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 3 | ||||
| Seitenbereich: | S. 724-729 | ||||
| Datum | 8 Oktober 2024 | ||||
| Institutionen | Medizin > Lehrstuhl für Chirurgie Medizin > Lehrstuhl für Röntgendiagnostik | ||||
| Projekte |
Gefördert von:
Deutsche Forschungsgemeinschaft (DFG)
(463450560)
| ||||
| Identifikationsnummer |
| ||||
| Stichwörter / Keywords | Complications, Evaluation algorithm, Living donor liver transplantation, Liver volumetry, Outcomes, Steatotic liver disease | ||||
| Dewey-Dezimal-Klassifikation | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status | Veröffentlicht | ||||
| Begutachtet | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden | Ja | ||||
| URN der UB Regensburg | urn:nbn:de:bvb:355-epub-750842 | ||||
| Dokumenten-ID | 75084 |
Downloadstatistik
Downloadstatistik