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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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INTENSIVE CARE  SMART 2003 - Milan, may 28-30, 2003


Minerva Anestesiologica 2003 May;69(5):365-70

language: Italian

Some remarks on the management of li­ver donor

Cerutti E. 1, Stratta C. 1, Schellino M.M. 1, Serra R. 2, Fop F. 1, Lupo F. 3, Salizzoni M. 3

1 Anestesia e Rianimazione 6, Azienda Ospedaliera S. Giovanni Battista, Torino, Italia
2 Dipartimento di Microbiologia, Azienda Ospedaliera S. Giovanni Battista, Torino, Italia
3 Chirurgia Generale 8, Centro Trapianto di Fegato, Azienda Ospedaliera S. Giovanni Battista, Torino, Italia


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We evaluated 481 liver donors in order to assess the incidence of positive cultures on samples obtained before harvesting, at harvesting and on preservation fluid; to determine factors related to positive cultures in the donor; to analyse the bacterial and fungal transmission from donor to recipient; to verify the influence of donor culture positivity on graft and patient survival. Cultures were positive in 232 of 481 (48%) donors. Bacteremia was present in 101 of 481 (20%) donors. Intensive care length of stay was significantly longer in culture-positive donors. A Gram-negative bacteria transmission from the infected donor to the graft recipient was proven in 1 case. No differences in 1-year survival and retransplantation rates were found between patients receiving livers from culture-positive or negative donors. In conclusion, even if rare, donor to host infection transmission is proven. Extended criteria for organ procurement may explain the high number of culture-positive donors we report. Careful microbiological surveillance and treatment can reduce the clinical negative impact on recipient outcome.

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