Comparison of experienced and inexperienced centers in cadaveric organ preparation for transplantation
Antalya Medicalpark Hospital, Department of General Surgery, Antalya, Turkey and University of Kyrenia Department of General Surgery, Girne, KKTC
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.
Keywords: Cadaveric Organ Transplantation; Harvesting; Errors.