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INTENSIVE CARE  SMART 2003 - Milan, may 28-30, 2003 Freefree

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


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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