Clinical transplantation · 2026
The Role of Liver Biopsy Findings in Uncontrolled Donation After Circulatory Death a 4-Year Single-Center Experience.
СтатьяНазвание и аннотация: Перевод в очереди
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Novelli Luca, Lazzeri Chiara, Ghinolfi Davide, Bonizzoli Manuela, Tatti Tiziana, Messerini Luca, Feltrin Giuseppe, Peris Adriano
Аннотация
BACKGROUND: Uncontrolled donors after circulatory death (uDCDs) are recognized as a potential donor pool. No data are so far available on liver biopsy findings in uDCDs. We aimed at assessing liver biopsy findings in uDCDs consecutively admitted to our Center from 2019 to 2023.
METHODS: Twenty nine utilized uDCD consecutively admitted at our Center from 2019 to 2023 were included. Liver biopsies were performed during organ procurement in all uDCDs.
RESULTS: The median time from cardiac arrest to normothermic regional perfusion (NRP) run was 144 min, while the median NRP duration was 6 h. The liver was retrieved but not transplanted in 12 donors (12/29, 41%) and transplanted in 10 donors (10/29, 35%). In 7 uDCDs, livers were not retrieved (24%). Ishak grading score 1-2 was observed in most biopsies (21/29, 72%). The incidence of microsteatosis <50% and macrosteatosis <30% was prevalent in our series (24/29, 82% and 22/29, 76%). Lobular infiltration was found in most biopsies (15/24, 63%), while hepatocellular focal necrosis was documented in the 45% (11/24). Severe IRI was found in a small percentage of uDCDs (4/24, 16%).
CONCLUSION: In our series, liver biopsy in uDCDs may provide clinicians with two different kinds of information. The first one may be mainly related to comorbidities and chronic damages, as indicated by the presence (and percentages) of micro/macrosteatosis and Ishak grading/score. The second one might provide insights into the ischemic-reperfusion injury of the liver, that is it might be related to the uDCD process itself.
METHODS: Twenty nine utilized uDCD consecutively admitted at our Center from 2019 to 2023 were included. Liver biopsies were performed during organ procurement in all uDCDs.
RESULTS: The median time from cardiac arrest to normothermic regional perfusion (NRP) run was 144 min, while the median NRP duration was 6 h. The liver was retrieved but not transplanted in 12 donors (12/29, 41%) and transplanted in 10 donors (10/29, 35%). In 7 uDCDs, livers were not retrieved (24%). Ishak grading score 1-2 was observed in most biopsies (21/29, 72%). The incidence of microsteatosis <50% and macrosteatosis <30% was prevalent in our series (24/29, 82% and 22/29, 76%). Lobular infiltration was found in most biopsies (15/24, 63%), while hepatocellular focal necrosis was documented in the 45% (11/24). Severe IRI was found in a small percentage of uDCDs (4/24, 16%).
CONCLUSION: In our series, liver biopsy in uDCDs may provide clinicians with two different kinds of information. The first one may be mainly related to comorbidities and chronic damages, as indicated by the presence (and percentages) of micro/macrosteatosis and Ishak grading/score. The second one might provide insights into the ischemic-reperfusion injury of the liver, that is it might be related to the uDCD process itself.