Christian Beltzer1, Markus Quante1, Myriam Rheinberger1, Hideo Andreas Baba2, Fuat Saner3, Falko Fend4, Thomas Biet5, Alfred Königsrainer1, Silvio Nadalin6. 1. Klinik für Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Tübingen, Deutschland. 2. Institut für Pathologie, Universitätsklinikum Essen, Essen, Deutschland. 3. Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Essen, Deutschland. 4. Institut für Pathologie und Neuropathologie, Universitätsklinikum Tübingen, Tübingen, Deutschland. 5. Deutsche Stiftung Organtransplantation, Frankfurt am Main, Deutschland. 6. Klinik für Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Tübingen, Deutschland. silvio.nadalin@med.uni-tuebingen.de.
Abstract
BACKGROUND: The value and safety of percutaneous liver biopsy (PLB) in brain-dead donors before organ removal and its impact on organ allocation and costs of liver transplantation (LT) in the Eurotransplant (ET) region is still a matter of ongoing debate. MATERIAL AND METHODS: A PLB was performed in 36 brain-dead organ donors. The complication rate, ultrasonography findings, macroscopic evaluation and histological results of PLB and donor characteristics were analyzed. Additionally, a nationwide survey was conducted among 11 liver transplantation experts. The need for PLB and its impact on the liver allocation process were evaluated. Possible cost savings were calculated for different scenarios based on cost data provided by the German Organ Transplantation Foundation. RESULTS: No complications of PLB were observed. The survey revealed that the PLB has a substantial impact on the allocation of donor organs, especially in organs fulfilling extended donor criteria (EDC). The cost calculation revealed an enormous potential for cost savings due to an optimized organ allocation process and avoidance of futile organ procurement. CONCLUSION: The PLB is a safe procedure and has tremendous potential for the optimization of the organ allocation process before organ procurement by reducing the cold ischemia time, avoiding unnecessarily discarding donor organs and saving costs. These data emphasize the clinical relevance and impact of PLB on the organ allocation process.
BACKGROUND: The value and safety of percutaneous liver biopsy (PLB) in brain-dead donors before organ removal and its impact on organ allocation and costs of liver transplantation (LT) in the Eurotransplant (ET) region is still a matter of ongoing debate. MATERIAL AND METHODS: A PLB was performed in 36 brain-dead organ donors. The complication rate, ultrasonography findings, macroscopic evaluation and histological results of PLB and donor characteristics were analyzed. Additionally, a nationwide survey was conducted among 11 liver transplantation experts. The need for PLB and its impact on the liver allocation process were evaluated. Possible cost savings were calculated for different scenarios based on cost data provided by the German Organ Transplantation Foundation. RESULTS: No complications of PLB were observed. The survey revealed that the PLB has a substantial impact on the allocation of donor organs, especially in organs fulfilling extended donor criteria (EDC). The cost calculation revealed an enormous potential for cost savings due to an optimized organ allocation process and avoidance of futile organ procurement. CONCLUSION: The PLB is a safe procedure and has tremendous potential for the optimization of the organ allocation process before organ procurement by reducing the cold ischemia time, avoiding unnecessarily discarding donor organs and saving costs. These data emphasize the clinical relevance and impact of PLB on the organ allocation process.
Authors: R S Markin; J L Wisecarver; S J Radio; R J Stratta; A N Langnas; K Hirst; B W Shaw Journal: Transplantation Date: 1993-12 Impact factor: 4.939
Authors: A M D'Alessandro; M Kalayoglu; H W Sollinger; R M Hoffmann; A Reed; S J Knechtle; J D Pirsch; G R Hafez; D Lorentzen; F O Belzer Journal: Transplantation Date: 1991-01 Impact factor: 4.939