Chirurgia del Fegato a Firenze!

Dal 1° Marzo 2023, Chirurgia del Fegato sarà all'Università di Firenze
AOUC Azienda Ospedaliero-Universitaria Careggi - Largo Brambilla, 3 - 50134 Firenze

Inizia il trapianto di fegato con donatori a cuore non battente.

Paolo Muiesan, al King’s College Hospital, a Londra, inizia un programma di trapianti di fegato con organi prelevati da donatori a cuore non battente.

In 3 anni ne realizzerà 60, che saranno il 10% dell”attività complessiva del centro.

Questa attività porterà allo sviluppo del prelievo da donatori a cuore fermo nel Regno Unito e nel resto del mondo.

La referenza bibliografica per questo evento è:

Paolo Muiesan, Raffaele Girlanda, Wayel Jassem, Hector Vilca Melendez, John O'Grady, Matthew Bowles, Mohamed Rela, Nigel Heaton: Single-center experience with liver transplantation from controlled non-heartbeating donors: A viable source of grafts. In: Annals of Surgery, vol. 242, no. 5, pp. 732 – 738, 2005, ISSN: 00034932, (Cited by: 153; All Open Access, Green Open Access).

Abstract

Background: To increase the number of livers available for transplantation a non-heartbeating donor (NHBD) liver transplant program was started after obtaining hospital ethical committee approval. Methods: Controlled donors with a warm ischemia of <30 minutes were considered. A 5-minute stand-off period was observed from asystole to skin incision. A super-rapid technique was used for the retrieval. Methods used to assess the suitability for transplantation included liver function tests, morphologic and histologic assessment, and hepatocyte viability testing. Results: Sixty livers were retrieved from NHBDs. Of these, 33 were judged suitable for transplantation. Of these one was exported and transplanted, and one could not be matched to a suitable recipient. A further 27 were not used because of liver appearance in 21, prolonged hypoxia and hypotension in 4, poor perfusion in 1, and donor malignancy in 1. Mean donor age was 39.4 years (range, 0.75-67 years). Causes of death were head trauma in 10 donors, intracranial bleed in 24, and anoxic/ischemic brain injury in 26. Mean warm ischemia time was 14.7 minutes (range, 7-40 minutes). Thirty-two patients were transplanted (one split liver), and the mean age of the recipients was 38.4 years (range, 0.7-72 years). All grafts had good early function except one right lobe split. There were 4 deaths resulting from ischemic brain injury, chronic rejection, biliary sepsis, and multiorgan failure following retransplantation for primary nonfunction. Overall patient and graft survival is 87% and 84%, respectively, at a median follow-up of 15 months. Conclusions: Early results suggest that controlled NHBDs are a significant new source of grafts, but careful donor selection and short cold ischemia are mandatory. Copyright © 2005 by Lippincott Williams & Wilkins.

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Chirurgia del Fegato all'Università di Firenze!

Chirurgia Epato-Bilio-Pancreatica

AOUC Azienda Ospedaliero-Universitaria Careggi
Largo Brambilla, 3 – 50134 Firenze

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