PATHOMORPHOLOGICAL CRITERIA FOR EVALUATING DONOR LIVER IN PREDICTING TRANSPLANT RESULTS

Currently, there is a high need for liver transplantation in patients with end-stage chronic diffuse liver diseases. The number of patients on the waiting list is increasing, but the number of potential donors remains low. One of the possible and actual approach to this problem is a definition of the optimal criteria for selecting liver transplants from suboptimal donors. The aim of the study was to determine the influence of morphological features of the donor liver on the post-transplant period. The results of examination and treatment of 18 patients with end-stage liver disease of various etiologies, operated in the hospital surgery clinic in the period from November 2016 to January 2020 years, were analyzed. Anamnestic, clinical, laboratory data of potential (effective and ineffective) donors, pathomorphological characteristics of liver transplants, and their relationship to the development of post-transplant complications, were studied. Studies established that when making a decision about using a graft, it is necessary to pay attention to the anamnestic and laboratory data: the duration of stay in the intensive care unit and the duration of artificial lung ventilation, AST and ALT levels. Their values are significantly higher in patients with low graft quality. The study showed that a visual evaluation of the graft with a zero-biopsy score according to the histological Protocol allows us to determine the graft that is undoubtedly suitable for use, that is important when removing cadaveric liver from suboptimal donors (donors with extended criteria). The main visual parameters are: the color of the parenchyma, form edges, texture, color and impression after holding over the surface of the liver, the color on the cut, color and texture after cold perfusion. Among the histological data: the degree of fat hepatosis, protein dystrophy, hepatocyte necrosis, as well as the final assessment of the Protocol used (3 tables, bibliography: 12 refs).

S. M. Kirov Military Medical Academy, Hospital surgery Department, orthotopic liver transplantation, donors with advanced criteria, fatty hepatosis, early graft dysfunction