TY - JOUR
T1 - How to face organ shortage in liver transplantation in an area with low rate of deceased donation
AU - Gruttadauria, Salvatore
AU - Pagano, Duilio
AU - Echeverri, Gabriel J.
AU - Cintorino, Davide
AU - Spada, Marco
AU - Gridelli, Bruno G.
PY - 2010
Y1 - 2010
N2 - Despite advances in patient selection, surgical technique, immunosuppression, and peri-operative management, the need for liver replacement exceeds organ availability. Moreover, in Italy, where the overall rate of cadaver donation is 21 donors per million per year, there are areas of the country, such as Sicily, where the rate of cadaver donation is 9.3 donors per million per year. In fact, this ongoing shortage of organs has led surgeons to develop innovative techniques in an attempt to expand the donor pool, and clinicians are continually modifying criteria to accept organs, particularly the previously defined expanded or marginal donor organs, which are now defined as extended criteria donor. Rarely, in certain specific settings alternative strategies based on the appropriate donor- recipient match allowed the use of grafts that otherwise would have been discarded due to anatomic anomalies. The organ shortage becomes more problematic in the scenario of re-transplantation where the use of a limited resource such as a liver graft must be weighed against the risk of a more difficult surgery.
AB - Despite advances in patient selection, surgical technique, immunosuppression, and peri-operative management, the need for liver replacement exceeds organ availability. Moreover, in Italy, where the overall rate of cadaver donation is 21 donors per million per year, there are areas of the country, such as Sicily, where the rate of cadaver donation is 9.3 donors per million per year. In fact, this ongoing shortage of organs has led surgeons to develop innovative techniques in an attempt to expand the donor pool, and clinicians are continually modifying criteria to accept organs, particularly the previously defined expanded or marginal donor organs, which are now defined as extended criteria donor. Rarely, in certain specific settings alternative strategies based on the appropriate donor- recipient match allowed the use of grafts that otherwise would have been discarded due to anatomic anomalies. The organ shortage becomes more problematic in the scenario of re-transplantation where the use of a limited resource such as a liver graft must be weighed against the risk of a more difficult surgery.
KW - Extended criteria donor
KW - Liver transplantation
KW - Living-related liver transplantation
KW - MELD score
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U2 - 10.1007/s13304-010-0030-y
DO - 10.1007/s13304-010-0030-y
M3 - Article
C2 - 21052892
AN - SCOPUS:80052952017
VL - 62
SP - 149
EP - 152
JO - Updates in Surgery
JF - Updates in Surgery
SN - 2038-131X
IS - 3-4
ER -