gms | German Medical Science

Introduction: The number of patients awaiting liver transplantation is steadily increasing with a growing shortage of donor organs. Furthermore, a large number of organs allocated has to be regarded as marginal organs. These organs have to be accepted by transplant centers to be able to overcome organ shortage.

Material and methods: Between 2003 and 2006 a total of 125 patients received a whole organ liver allograft. Marginal organs (MO) were defined as organs showing at least 2 of the following 5 attributes in the donor: donor > 60 years, CIT > 10h, sodium > 150 mmol/L, BMI > 25, ICU > 7 d. MO-recipients were compared with a group of non-marginal organ (NMO)-recipients. The primary end-point was one year survival. Secondary end-points were 1-year graft survival, number of retransplantations, number of acute rejections, biliary complications and liver function after one year.

Results: Seventy patients (56%) received a MO and 55 (44%) received a NMO. Demographic data and MELD scores were similar in both groups. One year survival was 82% in the MO and 86% in the NMO group revealing no significant differences between groups (p=0.339). One year graft survival MO 75% vs. Ninety-seven % NMO (p=0,755), acute rejections 33% MO vs. 20% NMO (p=0,156) and number of retransplantations: 5 MO vs 3 NMO (p=0.906) did not reveal significant differences between groups. However, biliary complications 48% MO vs. 28% NMO revealed significant differences (p=0.037).

Conclusion: Marginal donor organs do not impair one year overall and organ survival but result in an increased number of biliary complications.