Japanese national survey on declined liver allografts from brain‐dead donors: High decline rate but promising outcomes in allografts with moderate steatosis
Abstract Aim Liver allografts from brain‐dead donors, which were declined and were eventually not transplanted due to accompanying marginal factors, have never been surveyed in Japan. We surveyed the declined allografts and discussed the graft potential focusing on various marginal factors. Methods...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-07-01
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| Series: | Annals of Gastroenterological Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ags3.12661 |
| _version_ | 1797787341950025728 |
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| author | Yusuke Takemura Masahiro Shinoda Yasushi Hasegawa Yohei Yamada Hideaki Obara Minoru Kitago Mureo Kasahara Koji Umeshita Susumu Eguchi Yuko Kitagawa Hideki Ohdan Hiroto Egawa |
| author_facet | Yusuke Takemura Masahiro Shinoda Yasushi Hasegawa Yohei Yamada Hideaki Obara Minoru Kitago Mureo Kasahara Koji Umeshita Susumu Eguchi Yuko Kitagawa Hideki Ohdan Hiroto Egawa |
| author_sort | Yusuke Takemura |
| collection | DOAJ |
| description | Abstract Aim Liver allografts from brain‐dead donors, which were declined and were eventually not transplanted due to accompanying marginal factors, have never been surveyed in Japan. We surveyed the declined allografts and discussed the graft potential focusing on various marginal factors. Methods We collected data on brain‐dead donors between 1999 and 2019 from the Japan Organ Transplant Network. We divided their liver allografts into declined (nontransplanted) and transplanted ones, and then characterized declined ones focusing on their timepoints of decline and accompanying marginal factors. For each marginal factor, we calculated the decline rate from the number of declined and transplanted allografts, and assessed the 1‐year graft survival rate from transplanted allografts. Results A total of 571 liver allografts were divided into 84 (14.7%) declined and 487 (85.3%) transplanted ones. In the declined allografts, a majority was declined after laparotomy (n = 55, 65.5%), most of which had steatosis and/or fibrosis (n = 52). Out of the moderate steatotic (without F ≥ 2 fibrosis) allografts (n = 33), 21 were declined and 12 were transplanted, leading to a 63.6% decline rate. The latter 12 achieved a 92.9% 1‐year graft survival rate after transplantation. Comparison of donor background showed no significant difference between the declined and transplanted allografts. Conclusion Pathological abnormalities of steatosis/fibrosis seem to be the most common donor factor leading to graft decline in Japan. Allografts with moderate steatosis were highly declined; however, transplanted ones achieved promising outcomes. This national survey highlights the potential utility of liver allografts with moderate steatosis. |
| first_indexed | 2024-03-13T01:20:31Z |
| format | Article |
| id | doaj.art-991c6be970ca45fbb7fc00b158060d23 |
| institution | Directory Open Access Journal |
| issn | 2475-0328 |
| language | English |
| last_indexed | 2024-03-13T01:20:31Z |
| publishDate | 2023-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Gastroenterological Surgery |
| spelling | doaj.art-991c6be970ca45fbb7fc00b158060d232023-07-05T01:42:36ZengWileyAnnals of Gastroenterological Surgery2475-03282023-07-017465466510.1002/ags3.12661Japanese national survey on declined liver allografts from brain‐dead donors: High decline rate but promising outcomes in allografts with moderate steatosisYusuke Takemura0Masahiro Shinoda1Yasushi Hasegawa2Yohei Yamada3Hideaki Obara4Minoru Kitago5Mureo Kasahara6Koji Umeshita7Susumu Eguchi8Yuko Kitagawa9Hideki Ohdan10Hiroto Egawa11Department of Surgery Keio University School of Medicine Tokyo JapanDigestive Disease Center Mita Hospital, International University of Health and Welfare Tokyo JapanDepartment of Surgery Keio University School of Medicine Tokyo JapanDepartment of Surgery Keio University School of Medicine Tokyo JapanDepartment of Surgery Keio University School of Medicine Tokyo JapanDepartment of Surgery Keio University School of Medicine Tokyo JapanOrgan Transplantation Center National Center for Child Health and Development Tokyo JapanDepartment of Surgery Osaka International Cancer Institute Osaka JapanDepartment of Surgery Nagasaki University Graduate School of Biomedical Science Nagasaki JapanDepartment of Surgery Keio University School of Medicine Tokyo JapanDepartment of Gastroenterological and Transplant Surgery Hiroshima University Graduate School of Biomedical and Health Sciences Hiroshima JapanDepartment of Surgery, Institute of Gastroenterology Tokyo Women's Medical University Tokyo JapanAbstract Aim Liver allografts from brain‐dead donors, which were declined and were eventually not transplanted due to accompanying marginal factors, have never been surveyed in Japan. We surveyed the declined allografts and discussed the graft potential focusing on various marginal factors. Methods We collected data on brain‐dead donors between 1999 and 2019 from the Japan Organ Transplant Network. We divided their liver allografts into declined (nontransplanted) and transplanted ones, and then characterized declined ones focusing on their timepoints of decline and accompanying marginal factors. For each marginal factor, we calculated the decline rate from the number of declined and transplanted allografts, and assessed the 1‐year graft survival rate from transplanted allografts. Results A total of 571 liver allografts were divided into 84 (14.7%) declined and 487 (85.3%) transplanted ones. In the declined allografts, a majority was declined after laparotomy (n = 55, 65.5%), most of which had steatosis and/or fibrosis (n = 52). Out of the moderate steatotic (without F ≥ 2 fibrosis) allografts (n = 33), 21 were declined and 12 were transplanted, leading to a 63.6% decline rate. The latter 12 achieved a 92.9% 1‐year graft survival rate after transplantation. Comparison of donor background showed no significant difference between the declined and transplanted allografts. Conclusion Pathological abnormalities of steatosis/fibrosis seem to be the most common donor factor leading to graft decline in Japan. Allografts with moderate steatosis were highly declined; however, transplanted ones achieved promising outcomes. This national survey highlights the potential utility of liver allografts with moderate steatosis.https://doi.org/10.1002/ags3.12661deceased‐donor liver transplantationdonor selectionfibrosisgraft survivalsteatosis |
| spellingShingle | Yusuke Takemura Masahiro Shinoda Yasushi Hasegawa Yohei Yamada Hideaki Obara Minoru Kitago Mureo Kasahara Koji Umeshita Susumu Eguchi Yuko Kitagawa Hideki Ohdan Hiroto Egawa Japanese national survey on declined liver allografts from brain‐dead donors: High decline rate but promising outcomes in allografts with moderate steatosis Annals of Gastroenterological Surgery deceased‐donor liver transplantation donor selection fibrosis graft survival steatosis |
| title | Japanese national survey on declined liver allografts from brain‐dead donors: High decline rate but promising outcomes in allografts with moderate steatosis |
| title_full | Japanese national survey on declined liver allografts from brain‐dead donors: High decline rate but promising outcomes in allografts with moderate steatosis |
| title_fullStr | Japanese national survey on declined liver allografts from brain‐dead donors: High decline rate but promising outcomes in allografts with moderate steatosis |
| title_full_unstemmed | Japanese national survey on declined liver allografts from brain‐dead donors: High decline rate but promising outcomes in allografts with moderate steatosis |
| title_short | Japanese national survey on declined liver allografts from brain‐dead donors: High decline rate but promising outcomes in allografts with moderate steatosis |
| title_sort | japanese national survey on declined liver allografts from brain dead donors high decline rate but promising outcomes in allografts with moderate steatosis |
| topic | deceased‐donor liver transplantation donor selection fibrosis graft survival steatosis |
| url | https://doi.org/10.1002/ags3.12661 |
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