Abstract:
Background. The number of suitable donors for organ transplantation is limited in many
countries. This limitation can be overcome with the use of organs removed from marginal
donors (expanded-criteria donors [ECDs]). We examined the long-term results of 187
patients who underwent marginal cadaveric liver transplantation in our institution.
Methods. The data of patients who underwent cadaveric liver transplantation from
January 2007 to April 2014 were retrospectively reviewed. ECDs were evaluated by
considering 19 internationally accepted criteria. The clinical data of recipients including
age, clinical status, and Model for End-Stage Liver Disease (MELD) score were also
assessed.
Results. A total of 287 patients underwent cadaveric liver transplantation. A graft from
an ECD was used in 181 (63.06%) patients. The mean MELD score was 18.8. In all, 45
patients (24.86%) underwent transplantations for fulminant liver failure and 136 patients
(75.14%) underwent transplantations for other chronic conditions. The majority of donors
died of cerebrovascular disease and trauma. Only hypotension requiring inotropic drugs
and obesity significantly affected survival. The 90-day and 12-month survival rates of the
recipients who received a graft from an ECD were 51.93% and 46.2%, respectively.
Conclusions. The use of ECD allografts immediately and significantly expands the existing
donor pool. Because of persistent organ scarcity, pressure to use a greater proportion of the
existing donor pool will continue to increase.
