The utility of marginal donors in liver transplantation


  • Ronald W. Busuttil,

    Corresponding author
    1. Department of Surgery, Division of Liver and Pancreas Transplantation,Dumont-UCLA Transplant Center, Los Angeles, CA
    • Dumont-UCLA Transplant Center, Division of Liver and Pancreas Transplantation, 77-120 CHS, 10833 Le Conte Ave, Los Angeles, CA 90095. Telephone: 310-825-5318; FAX: 310-206-7760
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  • Koichi Tanaka

    1. Department of Surgery, Kyoto University, Kyoto, Japan
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The shortage of organs has led centers to expand their criteria for the acceptance of marginal donors. The combination of multiple marginal factors seems to be additive on graft injury. In this review, the utility of various marginal donors in patients requiring liver transplantation will be described, including older donors, steatotic livers, non-heart-beating donors, donors with viral hepatitis, and donors with malignancies. The pathophysiology of the marginal donor will be discussed, along with strategies for minimizing the ischemia reperfusion injury experienced by these organs. Finally, new strategies for improving the function of the marginal/expanded donor liver will be reviewed. (Liver Transpl 2003;9:651-663.)