[Skip to Navigation]
Views 336
Citations 0
Invited Commentary
August 5, 2020

A Move to Demarginalize the Liver Donor Allograft

Author Affiliations
  • 1Comprehensive Transplant Center, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus
JAMA Surg. 2020;155(10):932-933. doi:10.1001/jamasurg.2020.2520

Progress in liver transplantation during the past 30 years has been dramatic. The complexities of the operation have been standardized, candidate mortality has been objectified (Model for End-stage Liver Disease [MELD]), and survival has been maximized. Historically, the use of “marginal” liver allografts has often resulted in suboptimal results; thus, these grafts were often discarded except in the direst of circumstances. The more contemporary era of liver transplantation, perhaps the MELD era, has seen increasing use of marginal allografts owing to many factors, including the proliferation of transplant centers, growing transplant wait lists, intense competition for organs, and improvements in surgical, anesthetic, and critical care skills.1 The evaluation of the marginal donor allograft by Zhang et al2 in this issue of JAMA Surgery makes the case that earlier definitions of marginal are no longer accurate.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×