LIVER PROCUREMENT WITHOUT IN-SITU PORTAL PERFUSION

The outcome after liver transplantation when grafts were retrieved fro m the donor by the classical aortic and portal cooling (APC) method wa s compared with the outcome when exclusively aortic in situ perfusion (AC) was used. Retrospectively, 163 donor hepatectomies performed over a 20-month period were reviewed to analyze overall graft (APC n = 78, AC n = 85) and patient outcome. The global graft and pa. patient surv ival rates were not significantly lower in the APC group, except for 3 -month graft survival (APC 72%, AC 87%; P = 0.015). However, this coul d be unrelated to the technique. In a subgroup of 140 cases (APC n = 6 4, AC n = 76), a more detailed analysis was performed. Populations of donors and recipients were similar. The graft injury and the immediate graft function were not significantly different between both groups. A multivariate analysis shows that low donor weight (P = 0.007), donor hypernatremia (P = 0.014), and in situ portal perfusion (P = 0.045) w ere significant determinants of a higher postoperative peak of glutami c pyruvic transaminase. In summary in this series, routine human liver procurement using exclusive aortic perfusion seemed to be at least as safe as using a combined aortic and portal perfusion technique. This simplified method may also represent some advantages for combined panc reas and intestinal harvesting in the future.