Donor-Recipient MELD-Based Match in a Patient Who Required Three Liver Grafts in the Era of Nonstandard Donors: Case Report

Alfonso Wolfango Avolio, Salvatore Agnes, Massimo Siciliano, Brigida Eleonora Annicchiarico, Francesco Frongillo

Risultato della ricerca: Contributo in rivistaArticolo in rivista

1 Citazioni (Scopus)

Abstract

In recent studies, nonstandard donors and high Model for End-stage Liver Disease (MELD) values have been indicated as risk factors for both graft survival and patient survival. A recent debate concerns which donor and recipient match guarantees the best results in terms of early and late survival. To emphasize the role of the donor-recipient match, we have reported herein a complex case of a patient who changed his preoperative risk status, being transplanted three times using donors of different risk levels. At each transplant, the patient moved to a higher MELD class: first transplant MELD = 22; second transplant MELD = 37; third transplant MELD = 38. Only at the third transplant did the patient recover. Besides the liver, almost all his organs (kidneys, heart, lungs) recovered in a few weeks, as well. Unfortunately, severe cortical and subcortical brain damage remained a crucial limiting impairment, leading to death 5 months later, due to pulmonary infection, yet with a perfectly working liver. We underlined the role of donor factors to predict the outcome after liver transplantation in the MELD era. © 2008 Elsevier Inc. All rights reserved.
Lingua originaleEnglish
pagine (da-a)2067-2069
Numero di pagine3
RivistaTransplantation Proceedings
Volume40
DOI
Stato di pubblicazionePubblicato - 2008

Keywords

  • Aged
  • Carcinoma, Hepatocellular
  • Fatal Outcome
  • Female
  • Graft Survival
  • Histocompatibility Testing
  • Humans
  • Liver Neoplasms
  • Liver Transplantation
  • Male
  • Middle Aged
  • Reoperation
  • Tissue Donors

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