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Surgical Reminiscence
August 1999

An Interesting Intraoperative Decision

Arch Surg. 1999;134(8):901. doi:10.1001/archsurg.134.8.901

ONE NIGHT in March 1984, we were in the process of removing a donor liver for transplantation from a young trauma victim. After some dissection in the porta hepatis, we learned that the potential recipient had an electrocardiogram on admission that showed recent myocardial injury. Because the recipient did not have terminal liver disease, we attempted to place the liver at another center rather than risk further myocardial injury to the patient during the operation. There was no national system of organ sharing at this time, and placement of organs was usually done on an ad hoc basis from surgeon to surgeon. Our attempts in this case were unsuccessful. Having completed most of the dissection in the porta hepatis, we elected to shift gears and transplant the pancreas instead.

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