Technical characteristics and quality of grafts in liver procurement from brain-dead donors: A single-center study in Vietnamese population

Thanh Khiem Nguyen; Hong Son Trinh; Tuan Hiep Luong; Viet Khai Ninh; Gia Anh Pham; Ham Hoi Nguyen; Trung Nghia Bui; Kim Khue Dang; Tuan Hoang; Quang Nghia Nguyen

doi:10.1016/j.amsu.2021.102654

Technical characteristics and quality of grafts in liver procurement from brain-dead donors: A single-center study in Vietnamese population

Ann Med Surg (Lond). 2021 Jul 31:69:102654. doi: 10.1016/j.amsu.2021.102654. eCollection 2021 Sep.

Authors

Affiliations

¹ Department of Gastrointestinal and Hepato-pancreato-biliary Surgery, Bach Mai Hospital, Hanoi, Viet Nam.
² Department of Oncology, Viet Duc University Hospital, Hanoi, Viet Nam.
³ Department of Surgery, Hanoi Medical University, Hanoi, Viet Nam.
⁴ Center of Organ Transplantation, Viet Duc University Hospital, Hanoi, Viet Nam.

Abstract

Introduction: Donor liver graft quality plays an especially important role that contributes to the success of organ transplantation. Almost all local and international authors are interested in the techniques and results of transplantation, however, in Vietnam, there have not been any studies that report the results of liver procurement from brain-dead donors from a technical perspective as well as the morphology and function of the transplanted organ.

Materials and method: This study is descriptive cross-section study with analysis of retrospective occurrences of a series of cases of liver procurement from brain-dead donors from March 2010 to March 2020. All cases were proceeded the multiple organ procurement with warm liver dissection and in vivo cannulation and perfusion.

Results: The average age of brain-dead donors was 29.7 ± 10.7 (18-69), 92.16% of the harvested organs were of good quality macroscopically; and the rate of anatomical modification was 33.3% that occurred mostly in the left hepatic artery (LHA). Technically, warm dissection was proceeded in majority of cases (98,0%), the graft implantation was performed by this technique with mean cold ischemia time (CIT) of 190,0 ± 100,5 min and WIT of 74,0 ± 39,2 s. There were no complications relating to graft injuries occurring during procurement and no primary liver failure, good results accounted for 94.1% of the total number of transplants postoperatively.

Conclusion: Multiple organ procurement with warm liver dissection and in vivo cannulation and perfusion was a safe technique and may be effective by avoiding any donor's damages in cold-phase dissection.

Keywords: BDD, Brain-dead donors; BMI, Body mass index; Brain-dead donation; CD, Cold dissection; CIT, Cold ischemia time; GDA, Gastroduodenal artery; HA, Hepatic artery; HV, Hepatic vein; IVC, Inferior vena cava; LT, Liver transplantation; Liver transplantation; MOP, Multiple organ procurement; MPV, Main portal vein; Multiple organ procurement and transplantation; OLT, Orthotopic liver transplantation; PGD, Primary graft dysfunction; SA, Splenic artery; WD, Warm dissection; WIT, Warm ischemia time.