Transplantation of shipped donor livers

Between September 1988 and November 1991, 201 donor hepatectomies and transplantations were performed. Fifty-four livers (26.9%) were harvested by other teams and shipped for transplantation; 147 livers (73.1%) were procured by teams from our transplant center. Comparing the maximal postoperative serum-aminotransferases (s-AT), we evaluated the postischemic damage of shipped organs (AST 951±931 IU/l; ALT 820±666 IU/l) and nonshipped organs (AST 753±1256 IU/l; ALT 636±896 IU/l); this did not differ significantly. Donor-related factors, such as critical parameters (i.e., cardiac arrest, arterial hypotension, age over 50 years, or elevated preoperative s-AT), length of stay in the intensive care unit before harvesting, and cause of death showed similar patterns in both groups. The mean cold ischemia time in the group of shipped livers (12 h 10 min±4 h 22 min) and in the nonshipped livers (10 h 6 min±3 h 53 min) did not differ significantly. Five cases (2.5%) of a primary nonfunctioning graft presenting with significantly (P<0.001) elevated s-AT (AST 4944±2280 IU/l; ALT 3186±1918 IU/l) necessitated an early retransplantation. One organ was shipped and four organs were nonshipped, thus corresponding to their portion of all grafts. These data indicate that the transplantation of shipped livers is a safe procedure procedure, provided that procurement is done by experienced centers.