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No difference was found between groups regarding the number of HLA mismatches, incidence of delayed graft function, number of hospitalizations, or incidence of acute rejection. Recipients' age, cold ischemia time, and graft function 1 year after transplant were worse in the recipients A group. CONCLUSIONS Although kidney graft function was worse in recipients from elderly donors, this difference had no clinical relevance, showing a possible benefit in patient survival compared with permanence in dialysis, so this type of transplant could be considered for older recipients. Kidney Donor Profile Index (KDPI), derived from donor characteristics, was developed in the United States in an effort to devise an objective means of assessing donor organ suitability based on predicted graft survival. The objective of this study is to analyze the utility of KDPI to predict renal graft survival in Argentina. We conducted a retrospective national cohort study of adult patients who received a deceased donor renal transplantation in Argentina between January 2008 and December 2017. The graft survival was estimated according to the KDPI stratified by quartiles. A Kaplan-Meier analysis was used to calculate survival. A Cox regression was performed to estimate the probability of graft loss for each quart of the KDPI adjusted by receptor variables (age, diabetes, sex, and dialysis time) and cold ischemia time. In a Kaplan-Meier analysis, the graft survival decreases as the quartile of KDPI increases. Multivariate analysis shows that the increase in KDPI quartile and recipient's characteristics-such as age ≥60 years, diabetes, and dialysis time-were related to the probability of graft loss. In conclusion, the KDPI system could provide a guide to objectively assess the quality of organs offered for transplantation in Argentina. BACKGROUND Hepatic epithelioid hemangioendothelioma (HEHE) is a rare vascular tumor with indolent behavior in terms of malignancy. The treatment of choice is either resection in the case of resectable lesions or liver transplantation (LT) for the disseminated intrahepatic form. The aim of this study was to investigate the outcomes of patients with HEHE treated by LT. MATERIAL AND METHODS There were 18 patients with HEHE who underwent LT between 2002 and 2018 included in this retrospective study. The study group was comprised of young recipients (median age of 39 years) and mainly women (15 of 18; 83.3%). Two recipients had concomitant tumors of epithelioid hemangioendothelioma in the liver and lungs prior to LT. The survival probability was calculated using the Kaplan-Meier estimator. RESULTS According to histopathological data, none of the patients had a macrovascular invasion. In 4 patients (22.2%), the disease had spread to the hilar lymph nodes. The maximum diameter of the tumor in the studied group was 18 cm. The survival probability after 1, 5, and 15 years was 94.0%, 82.6%, and 41.3%, respectively. No disease recurrence was observed during a median follow-up of 65.9 months. CONCLUSION Liver transplantation provides favorable outcomes for selected patients with a hepatic form of epithelioid hemangioendothelioma. INTRODUCTION There currently exist no quantitative methods to assess graft viability before the donor procurement procedure. In Europe, around 20% of liver grafts evaluated "in situ" by an experienced surgeon are discarded. The aim of this study is to evaluate the use of the plasma disappearance rate indocyanine green (PDR-ICG) clearance in predicting liver graft rejection to avoid this 20% of futile surgeries. OBJECTIVES To evaluate PDR-ICG as a predictor of liver graft rejection in death brain donors compared with the gold standard evaluation by an experienced surgeon. MATERIAL AND METHODS Prospective observational single center study. From March 2017 to July 2019, 29 donors were included in the study, 17 were men and 12 women with a median age of 68 years ± 16.9 years. Donors had an intensive care unit stay of 2 days ± 4 days. PDR-ICG was measured with PICCO2 monitor. Indocyanine green clearance dose was 0.25 mg/kg injected intravenously in the operating room just before donor procurement procedure is initiated. The surgeon was unaware of the PDR-ICG measure until the decision of graft acceptance was taken. Data regarding the donors and biopsy results were included in a prospective database. RESULTS PDR-ICG measure could be obtained in 10 minutes in all of the cases included. The median PDR-ICG obtained was 18%/min (range, 2.4-31%/min). read more Graft rejection took place in 15 out of the 29 donors. PDR-ICG value was less than 10%/min in 6 of these rejected grafts and less than 15%/min in 10 donors. All donor grafts with PDR-ICG 15%. CONCLUSIONS In our study a plasma disappearance rate less then 10 would have identified the grafts that would be rejected, thus avoiding the displacement work and expense of the surgical team. These results should be confirmed in a multicentric study. BACKGROUND Advances in medical management and surgical technique have resulted in stepwise improvements in early post-transplant survival rates. Modifications in the surgical technique, such as the realization of the portocaval shunt (PCS), could influence survival rates. The aim of this study was to evaluate the mortality rate for 12 months after liver transplantation, analyzing the causes and risk factors related to its development and assessing the impact that PCS could have on them. METHODS A total of 231 recipients were included in the retrospective, longitudinal, and nonrandomized study. RESULTS The overall survival of the transplant was 85.2% (197 patients). The most frequent cause of death was infection (38.2%), followed by the multiorgan failure of multiple etiology (23.5%). Most of the risk factors related to mortality correspond to variables of the postoperative period. The results of the multivariate analysis identified the main risk factors for death the presence of surgical complications and the need for renal replacement therapy. In contrast, the performance of PCS exerted a protective effect, reducing the probability of death by 70%. CONCLUSIONS Despite the good results obtained in several studies, there is still debate regarding the benefit of its realization. In our study, PCS was a factor associated with a reduction in mortality, with a markedly lower probability of adverse events. However, we agree with other authors on the need for larger and randomized studies to adequately determine the validity of such results.
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