Ali Zarrinpar1, Coney Lee2, Emily Noguchi2, Hasan Yersiz2, Vatche G Agopian2, Fady M Kaldas2, Douglas G Farmer2, Ronald W Busuttil2. 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.
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.
Authors: H Yersiz; A M Cameron; I Carmody; M A Zimmerman; B S Kelly; R M Ghobrial; D G Farmer; R W Busuttil Journal: Transplant Proc Date: 2006-03 Impact factor: 1.066
Authors: W R Kim; J R Lake; J M Smith; M A Skeans; D P Schladt; E B Edwards; A M Harper; J L Wainright; J J Snyder; A K Israni; B L Kasiske Journal: Am J Transplant Date: 2015-01 Impact factor: 8.086
Authors: Kim M Olthoff; Laura Kulik; Benjamin Samstein; Mary Kaminski; Michael Abecassis; Jean Emond; Abraham Shaked; Jason D Christie Journal: Liver Transpl Date: 2010-08 Impact factor: 5.799
Authors: L Makowka; R D Gordon; S Todo; N Ohkohchi; J W Marsh; A G Tzakis; H Yokoi; J Ligush; C O Esquivel; M Satake Journal: Transplant Proc Date: 1987-02 Impact factor: 1.066
Authors: Lisette T Hoekstra; Wilmar de Graaf; Geert A A Nibourg; Michal Heger; Roelof J Bennink; Bruno Stieger; Thomas M van Gulik Journal: Ann Surg Date: 2013-01 Impact factor: 12.969
Authors: Hasan Yersiz; Coney Lee; Fady M Kaldas; Johnny C Hong; Abbas Rana; Gabriel T Schnickel; Jason A Wertheim; Ali Zarrinpar; Vatche G Agopian; Jeffrey Gornbein; Bita V Naini; Charles R Lassman; Ronald W Busuttil; Henrik Petrowsky Journal: Liver Transpl Date: 2013-03-17 Impact factor: 5.799
Authors: Vittorio Cherchi; Luigi Vetrugno; Giovanni Terrosu; Victor Zanini; Marco Ventin; Riccardo Pravisani; Francesco Tumminelli; Pier Paolo Brollo; Erica Boscolo; Roberto Peressutti; Dario Lorenzin; Tiziana Bove; Andrea Risaliti; Umberto Baccarani Journal: PLoS One Date: 2021-08-27 Impact factor: 3.240
Authors: Bo Dai; Nida El Islem Guissi; Lydia Frenzel Sulyok; Mitchell G Bryski; Yiqing Wang; Dongjin Wang; Sunil Singhal; Huiming Cai Journal: Ann Transl Med Date: 2022-01
Authors: Zoltan Czigany; Eve Christiana Craigie; Georg Lurje; Shaowei Song; Kei Yonezawa; Yuzo Yamamoto; Thomas Minor; René Hany Tolba Journal: Int J Mol Sci Date: 2020-09-14 Impact factor: 5.923