Systematic Reviews
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World J Hepatol. Jun 27, 2014; 6(6): 443-447
Published online Jun 27, 2014. doi: 10.4254/wjh.v6.i6.443
Reuse of liver grafts following the brain death of the initial recipient
Hideaki Tanaka, Vivian C McAlister, Mark A Levstik, Cameron N Ghent, Paul J Marotta, Douglas Quan, William J Wall
Hideaki Tanaka, Vivian C McAlister, Mark A Levstik, Cameron N Ghent, Paul J Marotta, Douglas Quan, William J WalL, Multi-Organ Transplant Program, London Health Sciences Centre, London, Ontario N6A 5A5, Canada
Hideaki Tanaka, Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba City, Ibaraki 305-8575, Japan
Vivian C McAlister, Canadian Armed Forces Health Service, Ottawa, Ontario K1A 0K2, Canada
Author contributions: Tanaka H participated in research design, performance of the research, and writing of the paper; McAlister VC participated in research design, data analysis and writing the paper; Levstik MA, Ghent CN, Marotta PI, Quan D and Wall WJ participated in research design and writing of the paper.
Correspondence to: Hideaki Tanaka, MD, Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennnoudai, Tsukuba City, Ibaraki 305-8575, Japan. hideakitnk@hotmail.com
Telephone: +81-29-8533094 Fax: +81-29-8533149
Received: February 11, 2014
Revised: April 18, 2014
Accepted: May 16, 2014
Published online: June 27, 2014
Abstract

AIM: To determine if there is a reasonable prospect of success of a re-use liver transplantation.

METHODS: We systematically searched for reports of liver graft re-use using electronic searches of PubMed and Web of Knowledge. We performed hand searches of references lists of articles reporting re-use of grafts.

RESULTS: A systematic review of the literature reveals 28 liver transplantations using previously transplanted grafts. First and second recipients ranged in age from 4 to 72 years and 29 to 62 years respectively. Liver disease in the first recipient was varied including 5 (18%) patients with fulminant liver failure who died subsequently of cerebral edema. The second transplantation was performed after a median interval of 5 d (one day-13 years). Viral hepatitis was present in 3 (11%) of the initial recipients and in 8 (29%) of final recipients. Hepatocellular carcinoma was present in 6 (21%) of the final recipients. Early survival after the final transplantation was 93%, whereas long-term survival was 78% with a mean follow-up of 23.3 (3-120) mo.

CONCLUSION: Outcomes of transplantation using previously transplanted grafts in this select population are similar to those seen with conventional grafts.

Keywords: Reuse, Liver graft, Brain death, Liver transplantation

Core tip: Reuse of a previously transplanted liver graft may be considered if the first recipient suffers neurological death at some time after liver transplantation.