Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Liver transplantation (LT) is considered as the only curable treatment for patients with end stage liver diseases. Post-operative complications include early allograft dysfunction (EAD), primary liver graft nonfunction (PNF), biliary stricture and ischemia, which are closely related to recipient’s mortality and morbidity. Evaluation of the quality of donor liver before transplantation not only affects the survival rate and incidence of complications, but also helps to achieve optimal utilization of donor organs. We aim to observe ultrastructural changes in donor liver by electron microscopy (EM) and then analyze the relationship between the quality of donor liver and prognosis.
*Methods: A total of 89 liver transplant recipients data was collected and analyzed for graft function recovery, which then divided into three groups as PNF, EAD and optimal graft function (OGF). Liver tissue samples were collected before re-vascularization, which then were examined under the transmission electron microscope. Organelles injury score (0.5-10) was evaluated by using a scoring system according to previous reported method with slightly modification.
*Results: The results revealed significantly higher scores in PNF group compared with OGF group (2.8±0.2 vs 3.7±1.0, P=0.039). Samples with higher score (>5) had worse liver functions compared with those with lower score (The mean peak ALT was 976.4± 116.6 U/L and 2071.2±918.9 U/L respectively, P= 0.041; The mean peak AST was 2581.5±314.0 U/L and 7869.6±2559.9 U/L respectively, P=0.006; The mean peak TBil was 187.0±15.7 umol/L and 188.0±34.0 umol/L respectively, P=0.036). Higher score group had a worse outcome after LT (19.5±5.7vs28.6±0.5 days, p= 0.004). The AUC of sER to predict 30 days survival was with statistical significance (0.72, P=0.042).
*Conclusions: Transmission electron microscope is one of feasible and effective strategy for evaluating the quality of donor liver and the patients prognosis. Higher organelles injury score group had a worse outcome.
To cite this abstract in AMA style:Chen M, Lin X, Chen Z, Han M, Ju W, He X. The Application of Electron Microscope Examination in Evaluation of Donor Liver Quality in Liver Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/the-application-of-electron-microscope-examination-in-evaluation-of-donor-liver-quality-in-liver-transplantation/. Accessed October 23, 2020.
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