Liver transplantation: use of a graft from a heart transplant recipient who became brain stemdead

The shortage of organ donors has led to progressive softening of selection criteria for organ donation. We report on hepatic transplantation in a 55-y ear-old woman with primary biliary cirrhosis, whose donor was a 50-year-old heart transplant recipient who became brain stem dead, due to cerebral ble eding 8 months after transplantation. An orthotopic liver transplantation w as performed The postoperative course was uneventful and the recipient was alive and had normal liver function after a 42-month follow-up. Analysis of the literature included ethical consideration, potential hepatotoxic effec ts of immunosuppressive drugs and modification of the graft immunogenicity, It confirms that transplanted patients should not be a priori excluded fro m organ donation. (C) 2000 Editions scientifiques et medicales Elsevier SAS .