In recent studies, nonstandard donors and high Model for End-stage Liver Disease (MELD) values have been indicated as risk factors for both graft survival and patient survival. A recent debate concerns which donor and recipient match guarantees the best results in terms of early and late survival. To emphasize the role of the donor-recipient match, we have reported herein a complex case of a patient who changed his preoperative risk status, being transplanted three times using donors of different risk levels. At each transplant, the patient moved to a higher MELD class: first transplant MELD = 22; second transplant MELD = 37; third transplant MELD = 38. Only at the third transplant did the patient recover. Besides the liver, almost all his organs (kidneys, heart, lungs) recovered in a few weeks, as well. Unfortunately, severe cortical and subcortical brain damage remained a crucial limiting impairment, leading to death 5 months later, due to pulmonary infection, yet with a perfectly working liver. We underlined the role of donor factors to predict the outcome after liver transplantation in the MELD era. © 2008 Elsevier Inc. All rights reserved.

Avolio, A. W., Barbarino, R., Siciliano, M., Annicchiarico, B. E., Frongillo, F., Agnes, S., Castagneto, M., Donor-Recipient MELD-Based Match in a Patient Who Required Three Liver Grafts in the Era of Nonstandard Donors: Case Report, <<TRANSPLANTATION PROCEEDINGS>>, 2008; 40 (6): 2067-2069. [doi:10.1016/j.transproceed.2008.06.004] [http://hdl.handle.net/10807/141897]

Donor-Recipient MELD-Based Match in a Patient Who Required Three Liver Grafts in the Era of Nonstandard Donors: Case Report

Avolio, Alfonso Wolfango;Siciliano, Massimo;Annicchiarico, Brigida Eleonora;Frongillo, Francesco;Agnes, Salvatore;
2008

Abstract

In recent studies, nonstandard donors and high Model for End-stage Liver Disease (MELD) values have been indicated as risk factors for both graft survival and patient survival. A recent debate concerns which donor and recipient match guarantees the best results in terms of early and late survival. To emphasize the role of the donor-recipient match, we have reported herein a complex case of a patient who changed his preoperative risk status, being transplanted three times using donors of different risk levels. At each transplant, the patient moved to a higher MELD class: first transplant MELD = 22; second transplant MELD = 37; third transplant MELD = 38. Only at the third transplant did the patient recover. Besides the liver, almost all his organs (kidneys, heart, lungs) recovered in a few weeks, as well. Unfortunately, severe cortical and subcortical brain damage remained a crucial limiting impairment, leading to death 5 months later, due to pulmonary infection, yet with a perfectly working liver. We underlined the role of donor factors to predict the outcome after liver transplantation in the MELD era. © 2008 Elsevier Inc. All rights reserved.
2008
Inglese
Avolio, A. W., Barbarino, R., Siciliano, M., Annicchiarico, B. E., Frongillo, F., Agnes, S., Castagneto, M., Donor-Recipient MELD-Based Match in a Patient Who Required Three Liver Grafts in the Era of Nonstandard Donors: Case Report, <<TRANSPLANTATION PROCEEDINGS>>, 2008; 40 (6): 2067-2069. [doi:10.1016/j.transproceed.2008.06.004] [http://hdl.handle.net/10807/141897]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/141897
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