Technical characteristics and quality of grafts in liver procurement from brain-dead donors: A single-center study in Vietnamese population

• Published in: Annals of medicine and surgery Vol. 69; p. 102654
• Main Authors: Nguyen, Thanh Khiem, Trinh, Hong Son, Luong, Tuan Hiep, Ninh, Viet Khai, Pham, Gia Anh, Nguyen, Ham Hoi, Bui, Trung Nghia, Dang, Kim Khue, Hoang, Tuan, Nguyen, Quang Nghia
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2021; Elsevier
• Subjects: Brain-dead donation; Case Series; Liver transplantation; Multiple organ procurement and transplantation; CD; BDD; WIT; GDA; LT; Multiple organ procurement and transplantation; PGD; WD; HV; SA; CIT; MOP; MPV; OLT; IVC; Brain-dead donation; HA; Liver transplantation; BMI; LT, Liver transplantation; HA, Hepatic artery; BMI, Body mass index; CD, Cold dissection; HV, Hepatic vein; SA, Splenic artery; WD, Warm dissection; WIT, Warm ischemia time; PGD, Primary graft dysfunction; MPV, Main portal vein; MOP, Multiple organ procurement; BDD, Brain-dead donors; GDA, Gastroduodenal artery; CIT, Cold ischemia time; IVC, Inferior vena cava; OLT, Orthotopic liver transplantation
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2021.102654

Donor liver graft quality plays an especially important role that contributes to the success of organ transplantation. Almost all local and international authors are interested in the techniques and results of transplantation, however, in Vietnam, there have not been any studies that report the results of liver procurement from brain-dead donors from a technical perspective as well as the morphology and function of the transplanted organ. This study is descriptive cross-section study with analysis of retrospective occurrences of a series of cases of liver procurement from brain-dead donors from March 2010 to March 2020. All cases were proceeded the multiple organ procurement with warm liver dissection and in vivo cannulation and perfusion. The average age of brain-dead donors was 29.7 ± 10.7 (18–69), 92.16% of the harvested organs were of good quality macroscopically; and the rate of anatomical modification was 33.3% that occurred mostly in the left hepatic artery (LHA). Technically, warm dissection was proceeded in majority of cases (98,0%), the graft implantation was performed by this technique with mean cold ischemia time (CIT) of 190,0 ± 100,5 min and WIT of 74,0 ± 39,2 s. There were no complications relating to graft injuries occurring during procurement and no primary liver failure, good results accounted for 94.1% of the total number of transplants postoperatively. Multiple organ procurement with warm liver dissection and in vivo cannulation and perfusion was a safe technique and may be effective by avoiding any donor's damages in cold-phase dissection. •Liver transplantation in brain-dead donors had developed rapidly in recent decades.•Several techniques were proceeded depend on experience and faculties of institute.•In vivo perfusion and warm dissection can avoid graft's damages in cold dissection.•Long-term follow-up is needed to evaluate quality of graft and overall survival.