Donor criteria for liver transplantation:A comparative study of the effects of donor liver selection

In a case-control study, the relevance of donor parameters used for donor selection on final transplant outcome was studied. Two matched groups of 17 donors were created: one group of 'ideal' donors and a control group not meeting the criteria for 'ideal' donors. Recipients of livers from both groups were matched for liver disease, Karnovsky-score, Child-Pugh sumscore, and preservation solution used (EuroCollins or UW-solution). The effect of the donor liver selection criteria on transplant outcome was measured by comparing the following parameters in both groups: intra-operative blood loss, the ALT in the first 3 days after grafting, occurrence of major postoperative complications, ICU-stay and graft and patient survival. Although, in the control group, bacterial infections and abdominal hemorrhages occurred more frequently, while leakage from the bile duct anastomosis was more prevalent in the 'ideal' group, the results for the other parameters studied indicated no statistical differences between the two groups. It was concluded that adherence to strict selection criteria for liver donors did not improve final transplant outcome. However, use of less strict criteria possibly may cause a more complicated course directly after transplantation.