Status:
Ready to upload
Record number:
1674
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Not uncommon and likely avoidable. A total of 7146 livers were recovered from deceased donors during the study (procured between 2000 and 2010). Surgical recovery injuries of the liver occurred in 1001 procedures (14.0%) and resulted in a non-transplanted organ. Aberrant anatomy was reported to occur in 30.6% of all liver donors but surgical errors did not always occur in the presence of unusual anatomy.
Time to detection:
Immediately known at time of procurement of the liver.
Alerting signals, symptoms, evidence of occurrence:
There were no differences in terms of vascular injuries between livers procured from DCD (donation after circulatory death) and DBD (donation after brain death) donors, although capsular injuries occurred more frequently in DCD organs.
Demonstration of imputability or root cause:
Due to a desire to minimize both warm and cold ischaemia during recovery, less dissection and more rapid removal occurs. This combination makes procurement from DCD donors a more challenging operation. Ensuring there is an adequately skilled surgical team available for procurement is vital to improving the utilization of livers.
Groups audience:
Keywords:
Suggest new keywords:
liver, organ, procurement, injury, DCD
Reference attachment:
Suggest references:
Ausania, F., White, S.,A., Coates, R., Hulme, W. and Manas, M. (2013). Liver damage during organ procurement in donation after circulatory death compared with donation after brain death. Bristish Journal of Surgery 100: 381-386
Expert comments for publication:
This is a detailed, 10-year long retrospective study and report by NHS Blood and Transplant (NHSBT). Similar studies and outcomes from other transplant programs would serve to better understand frequency and reasons for damage to the liver at procurement.