A preliminary european liver and intestine transplant association-european liver transplant registry study on informed recipient consent and extended criteria liver donation

The European Liver and Intestine Transplant Association (ELITA) and the European Liver Transplant Registry (ELTR) coordinated the distribution to European liver transplantation centers of an electronic questionnaire, developed by the first author, concerning the definition of extended criteria liver donation (ECD) and the implication for informed consent of transplant recipients. Completed questionnaires were received from 35 centers. All centers accepted ECD liver donors. The criteria for defining a liver donor as ECD were as follows: steatosis in 33 centers (94%); age up to 80 years in 15 centers (43%); serum sodium >165 mmol/L in 25 centers (71%); intensive care unit (ICU) stay with ventilation longer than 7 days in 17 centers (48%); aspartate aminotransferase (AST) >90 U/L, in 6 centers (17%); body mass index (BMI) >30 in 19 centers (54%); alanine aminotransferase (ALT) >105 U/L in 8 centers (23%); serum bilirubin >3 mg/dL in 15 centers (43%); and all criteria together in 2 centers (6%). Thirty-one centers informed the transplantation candidate of the ECD status of the donor, 20 (65%) when the patient registered for transplantation, 1 (3%) when an ECD liver became available, and 10 centers (32%) on both occasions. Thirteen centers required the liver transplantation candidate to sign a special consent form. Twenty centers informed the potential recipient of the donor's serology. Only 6 centers informed the potential recipient of any high-risk behavior of the donor.