Emir Hoti1, Eric Levesque, Mylène Sebagh, Helen M Heneghan, Meriem Khalfallah, Denis Castaing, Daniel Azoulay. 1. 1 AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France. 2 Liver Transplant Unit, Saint Vincent's University Hospital, Elm Park, Dublin 4, Ireland. 3 AP-HP Hôpital Henri Mondor, Réanimation digestive et transplantation hépatique, Créteil, France. 4 AP-HP Hôpital Paul Brousse, Service d'Anatomopathologie, Villejuif, France. 5 AP-HP Hôpital Henri Mondor, HPB and Liver Transplantation unit, Créteil, France. 6 Address correspondence to: Eric Levesque, M.D., Réanimation digestive et Transplantation hépatique, Service d'Anesthésie et des Réanimations Chirurgicales, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.
Abstract
INTRODUCTION: Hanging is a common method of suicide globally, and the incidence is increasing at an alarming rate. The purpose of this study was to analyze our experience with the use of liver grafts from donors whose cause of death is suicidal hanging and to evaluate the outcome of the graft recipients. PATIENTS AND METHODS: Twenty-four consecutive patients were transplanted with grafts obtained from suicidal hanging donors. These patients (group A) were case-matched to 24 patients who underwent liver transplantation with a liver graft from a brain-dead donor whose cause of death was not hanging or strangulation (group B). The analysis was focused on postoperative complications, graft, and recipient outcomes. RESULTS: Donors in group A showed a significantly higher mean [±2 standard deviation] serum aspartate aminotransferase and alanine aminotransferase compared to group B (aspartate aminotransferase, 168[166] vs. 57[67] IU/L; P=0.006; alanine aminotransferase, 151[197] vs. 58[103] IU/L; P=0.049); however, there was no difference in graft failure rates between the two groups [8.3% (n=2) in each group]. Overall 30-day postoperative morbidity, 1-year and 5-year survivals were comparable in both groups (P=0.96, P=0.35, P=0.69, respectively). CONCLUSION: The use of grafts from suicidal hanging donors (without hemodynamic instability and with downward trend in the donor transaminases) is not associated with higher post-liver transplantation complication rates and does not negatively influence recipient's outcome.
INTRODUCTION: Hanging is a common method of suicide globally, and the incidence is increasing at an alarming rate. The purpose of this study was to analyze our experience with the use of liver grafts from donors whose cause of death is suicidal hanging and to evaluate the outcome of the graft recipients. PATIENTS AND METHODS: Twenty-four consecutive patients were transplanted with grafts obtained from suicidal hanging donors. These patients (group A) were case-matched to 24 patients who underwent liver transplantation with a liver graft from a brain-dead donor whose cause of death was not hanging or strangulation (group B). The analysis was focused on postoperative complications, graft, and recipient outcomes. RESULTS: Donors in group A showed a significantly higher mean [±2 standard deviation] serum aspartate aminotransferase and alanine aminotransferase compared to group B (aspartate aminotransferase, 168[166] vs. 57[67] IU/L; P=0.006; alanine aminotransferase, 151[197] vs. 58[103] IU/L; P=0.049); however, there was no difference in graft failure rates between the two groups [8.3% (n=2) in each group]. Overall 30-day postoperative morbidity, 1-year and 5-year survivals were comparable in both groups (P=0.96, P=0.35, P=0.69, respectively). CONCLUSION: The use of grafts from suicidal hanging donors (without hemodynamic instability and with downward trend in the donor transaminases) is not associated with higher post-liver transplantation complication rates and does not negatively influence recipient's outcome.
Authors: Patrick B Trotter; Ina Jochmans; William Hulme; Matthew Robb; Christopher Watson; James Neuberger; J Andrew Bradley Journal: Am J Transplant Date: 2018-07-30 Impact factor: 8.086
Authors: Ryan P Watts; Izabela Bilska; Sara Diab; Kimble R Dunster; Andrew C Bulmer; Adrian G Barnett; John F Fraser Journal: Intensive Care Med Exp Date: 2015-11-24