Comparison of experienced and inexperienced centers in cadaveric organ preparation for transplantation
Comparison of experienced and inexperienced centers in cadaveric organ preparation for transplantation
Aim: The aim of this study is to compare the experienced centers with inexperienced centers due to the harvesting of cadaveric organs. Despite the improvements in medical treatments, the most effective treatment method for chronic renal failure and liver cirrhosis is organ transplantation. Organ transplantation preparation has some differences depending on whether the donor type is live or cadaveric. The perfusion, extraction, packaging and transport of cadaveric organs require special care and procedures.Material and Methods: Liver and kidney cadaveric organs which were harvested and sent by external centers were evaluated before transplantation in Antalya Medicalpark Organ Transplantation Department between January 2016 and August 2018. Organs were evaluated as good or bad in three groups according to perfusion, surgical extraction technique and packaging method. The external centers who harvested and transport the organs were divided into two groups as experienced or inexperienced centers according to the number of organ transplantations performed by them in one year.Results: Antalya Medicalpark Organ Transplantation Department admitted 17 cadaveric liver and 82 cadaveric kidney organs from external centers for transplantation between January 2016 and August 2018. According to the evaluation of packaging, 12 liver cadaveric organs were considered as good and 5 of them as bad. The packaging of 3 of the incoming kidneys was considered poor. According to the evaluation of extraction, 7 kidneys were considered as bad. Injury in the renal artery and vein hilus level, inappropriate cut in the ureter from the renal pelvis, short cuts of renal arteries, dissection were the injuries we encountered. According to the evaluation of perfusion, 6 kidneys that were clotted in the renal vein were considered to be poor.Conclusions: Organ extraction operations and organ preservation procedures directly affect transplant success. Therefore the harvesting team should control all the stages and procedures from extraction to packaging carefully.
___
- 1.
Özbilgin M, Ünek T, Egeli T, et al. Complications in donors using right liver graft: analysis of 280 consecutive cases,” Transplant Proc. 2017;49:580-6.
- 2.
Sarier M, Demir M, Goktas S, et al. Results of real-time multiplex polymerase chain reaction assay in renal transplant recipients with sterile pyuria. Transplant Proc. 2017;49:1307-11.
- 3.
Rueb J, Kuehn P, Viebahn R, et al. Predicting quality of deceased donor kidneys: The harvesting surgeon as a prognostic factor? Transplant Proc.2013;45:1360-2.
- 4.
Sabuncuoğlu MZ. Does the establishment of organ transplant center effect the organ donation in the region? SDU Tıp Fakultesi Dergisi 2017;24:8-11.
- 5.
Yıldız İ, Sabuncuoğlu MZ, Solmaz FA, et al. Establishment of Suleyman Demirel University Medical Faculty Hospital organ transplant center. SDU Tıp Fakultesi Dergisi 2018;25:228-3.
- 6.
Yavuz HA, Tekin S, Yuksel Y, et al. Donors with hepatitis b surface antigen positivity. Transplant Proc. 2015;47:1312-4.
- 7.
http://www.irodat.org/?p=database&c=TR#data access date: 2017
- 8.
http://www.irodat.org/?p=database&c=US#dataaccess date: 2017
- 9.
http://www.irodat.org/?p=database&c=ES#data access date: 2017
- 10.
Tay M. Türkiye’de doku ve organ naklinin önemi. Sağlık Akademisyenleri Dergisi.2016;3:106-10.
- 11.
Oruc A, Ersoy A, Yavuz A, et al. Kadavra vericiden böbrek nakli adaylarının çağrı sonrası merkezde elenme nedenleri. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi. 2018;27:82-6.
- 12.
Topbaş E, Bingöl G. Türkiye’de kadavra donörden gerçekleştirilen organ nakline etki eden faktörler. Nefroloji Hemşireliği Dergisi 2016:1-12.
- 13.
Cemalettin Koç. Kadavra donörlerde standart ve modifiye standart harvesting tekniklerinin karşılaştırılması. Uzmanlık Tezi. İnönü Üniverstesi Tıp Fakültesi. 2012.
- 14.
Karaciğer Transplantasyonu. Bölüm 24. Karaciğer Transplantayonunda Cerrahi Teknik. Özkardeşler T, Tekin İ, Ünek T. Ven Kitap 2015
- 15.
Tekin A, Küçükkartallar T, Çakır M. Organ alınması. Türkiye Klinikleri Genel Cerrahi, Trasnplantasyon Özel Sayısı 2013;1:35-8.
- 16.
Yücetin L. Türkiye ’ de Kadavra kaynaklı organ teminindeki sorunların çözüinü : eğitimli organ nakil koordinatörteri a solution for problems in cadaveric donation in Turkey : educated transplant coordinators. SSK Tepecik Hast Derg. 2003;13:7-10.