The marginal donor: a single-center experience in orthotopic liver transplantation

Background - Since marginal grafts are a solution to deal with the shortage of organ donors, its use became more common worldwide, and the literature had shown its effectiveness in the liver transplantation (LT) outcomes. Aim - To present a single center experience, at the Liver Transplantation Unit of Oswaldo Cruz University Hospital, with orthotopic LT using marginal organ donors. Methods - Retrospectivety review of 137 orthotopic LT using marginal grafts between 1999 and 2006, with a minimum 180 days follow-up. The receptors were classified according to postoperative initial graft function as normal function (NF) and primary dysfunction (PD). Results - No significant statistic difference was observed between groups NF and PD concerning the following donor's parameters: donor's age, serum sodium, prothrombine time, liver steatosis, serum transaminasis, blood pressure, vasoactive drugs, body mass index, heart attack prior organ donation, non-heart-beating donor and warm ischemia time. The survival curves' analysis (Kaplan-Meier) of patients or patients' grafts which received LT from ideal donors versus marginal donors showed no significant difference. Conclusions - The results permit to recommend the use of liver marginal grafts, including that ones from non-heart-beating donors.