A rapid, reproducible, noninvasive predictor of liver graft survival

Ali Zarrinpar, Coney Lee, Emily Noguchi, Hasan Yersiz, Vatche G. Agopian, Fady M. Kaldas, Douglas G. Farmer, Ronald W. Busuttil

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Background Clinical and laboratory criteria are not reliable predictors of deceased donor liver graft quality. Intraoperative assessment of experienced surgeons is the gold standard. Standardizing and quantifying this assessment is especially needed now that regional sharing is the rule. We prospectively evaluated a novel, simple, rapid, noninvasive, quantitative measure of liver function performed before graft procurement. Materials and methods Using a portable, finger-probe-based device, indocyanine green plasma disappearance rates (ICG-PDR) were measured in adult brain-dead donors in the local donor service area before organ procurement. Results were compared with graft function and outcomes. Both donor and recipient teams were blinded to ICG-PDR measurements. Results Measurements were performed on 53 consecutive donors. Eleven liver grafts were declined by all centers because of quality; the other 42 grafts were transplanted. Logistic regression analysis showed ICG-PDR to be the only donor variable to be significantly associated with 7-d graft survival. Donor risk index, donor age, and transaminase levels at peak or procurement were not significantly associated with 7-d graft survival. Conclusions We report the successful use of a portable quantitative means of measuring liver function and its association with graft survival. These data warrant further exploration in a variety of settings to evaluate acceptable values for donated liver grafts.

Original languageEnglish (US)
Pages (from-to)183-190
Number of pages8
JournalJournal of Surgical Research
Volume197
Issue number1
DOIs
StatePublished - Jul 1 2015

Keywords

  • Deceased donor
  • Indocyanine green
  • Liver graft assessment
  • Liver graft utilization
  • Organ procurement

ASJC Scopus subject areas

  • Surgery

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