Grezzana FTJM, Chedid AD, Leipnitz I, Chedid MF, Kruel CDP, Kruel CRP

Language: English
References: 14
Page: 281-285
PDF size: 86.08 Kb.

ABSTRACT

Organs from deceased donors with traumatic abdominal injury, peritoneal contamination and open abdomen are usually discarded due to risks of transmission of severe infections to the recipient. There are no specific recommendations regarding organ utilization from these donors, but they might be an unexplored source able to attenuate organ shortage. Herein, the first successful report of a case involving liver transplantation using a liver allograft procured from a deceased donor with an open abdomen is outlined. This donor was a young trauma patient in which peritoneal contamination had occurred following a gunshot wound. Also included in this the report is liver transplant from a donor, who also was a trauma victim with an enteric perforation. The decision-making process to accept liver allografts from donors with a greater risk of peritoneal infection involved the absence of uncontrolled sepsis or visible contamination of the cavity. Appropriate donor-recipient matching and adequate anti-infectious management might have contributed to a favorable outcome, which suggest that these donors can be used as alternatives to reduce organ shortage.

REFERENCES

1. 1 Renz JF, Kin C, Kinkhabwala M, Jan D, Varadarajan R, Goldstein M, Brown R Jr, et al. Utilization of extended donor criteria liver allografts maximizes donor use and patient access to liver transplantation. Ann Surg 2005; 242: 556-63; discussion 563-5.

2. Freeman RB, Giatras I, Falagas ME, Supran S, O’Connor K, Bradley J, Snydman DR, et al. Outcome of transplantation of organs procured from bacteremic donors. Transplantation 1999; 68: 1107-11.

3. Watkins AC, Vedula GV, Horan J, Dellicarpini K, Pak SW, Daly T, Samstein B, et al. The deceased organ donor with an “open abdomen”: proceed with caution. Transpl Infect Dis 2012; 14: 311-5.

4. Lopez-Navidad A, Caballero F. Extended criteria for organ acceptance. Strategies for achieving organ safety and for increasing organ pool. Clin Transplant 2003; 17: 308-24.

5. Lumbreras C, Sanz F, González A, Pérez G, Ramos MJ, Aguado JM, Lizasoain M, et al. Clinical significance of donor- unrecognized bacteremia in the outcome of solid-organ transplant recipients. Clin Infect Dis 2001; 33: 722-6.

6. Doucette KE, Al-Saif M, Kneteman N, Chui L, Tyrrell GJ, Kumar D, Humar A. Donor-derived bacteremia in liver transplant recipients despite antibiotic prophylaxis. Am J Transplant 2013; 13: 1080-3.

7. Outerelo C, Gouveia R, Mateus A, Cruz P, Oliveira C, Ramos A. Infected donors in renal transplantation: expanding the donor pool. Transplant Proc 2013; 45: 1054-6.

8. Chaim FH, Boin IF, Ataide EC, Stucchi RS. Perfusion fluid contamination in relation to recipient survival and acute cellular rejection in orthotopic liver transplantation: retrospective analysis. Transplant Proc 2011; 43: 1313-5.

9. Audet M, Piardi T, Panaro F, Ghislotti E, Gheza F, Cag M, Jarzembowski TM, et al. Incidence and clinical significance of bacterial and fungal contamination of the preservation solution in liver transplantation. Transpl Infect Dis 2011, 13: 84-8.

10. Papadopoulos VN, Michalopoulos A, Apostolidis S, Paramythiotis D, Ioannidis A, Mekras A, Panidis S, et al. Surgical management of colorectal injuries: colostomy or primary repair? Tech Coloproctol 2011; 15: S63-S66.

11. Musa O, Ghildiyal JP, C Pandey M. 6 year prospective clinical trial of primary repair versus diversion colostomy in colonic injury cases. Indian J Surg 2010; 72: 308-11.

12. Ruiz I, Gavaldà J, Monforte V, Len O, Román A, Bravo C, Ferrer A, et al. Donor-to-host transmission of bacterial and fungal infections in lung transplantation. Am J Transplant 2006; 6: 178-82.

13. Goldberg E, Bishara J, Lev S, Singer P, Cohen J. Organ transplantation from a donor colonized with a multidrugresistant organism: a case report. Transpl Infect Dis 2012; 14: 296-9.

14. Doucette KE, Al-Saif M, Kneteman N, Chui L, Tyrrell GJ, Kumar D, Humar A. Donor-derived bacteremia in liver transplant recipients despite antibiotic prophylaxis. Am J Transplant 2013; 13: 1080-3.