Table 1.
Comparison of graft details and perfusion protocols for the two livers which developed metHb.
| Liver 1 | Liver 2 | |
|---|---|---|
| GRAFT DETAILS | ||
| Donor type | DBD | DBD |
| Cause of death | Intracranial hemorrhage | Intracranial hemorrhage |
| Sex | F | M |
| Age | 53 | 45 |
| Comorbidities | Nil | Nil |
| Alcohol history | Excessive (7-9 U/day) | Excessive (7-9 U/day) |
| Steatosis | Severe steatosis* (>50% macrovesicular steatosis on biopsy) | Severe steatosis* (80% total steatosis, 50% macrovesicular steatosis on biopsy) |
| Liver weight | 2.5 kg | 2.2 kg |
| Cold ischaemic time | 20 h 33 min | 9 h 39 min |
| PERFUSION DETAILS | ||
| Device used | Medtronic™ perfusion equipment | OrganOx Metra™ |
| Oxygen carrier | 3 units of human red blood cells | 3 units of human red blood cells |
| Perfusate constituents | Succinylated gelatin (Isoplex) Heparin Sodium bicarbonate Calcium gluconate Cefuroxime |
Succinylated gelatin (gelofusine) Heparin Sodium bicarbonate Magnesium sulfate Fluconazole + Meropenem Hydrocortisone Parvolex (Acetylcysteine) Aminoven |
| Infusions | Heparin Epoprostenol Insulin (6.9 units/h) Cernavit + Synthamin 9 |
Heparin Epoprostenol Insulin (6.7 units/h) Bile salts |
Similarities between the two cases may be risk factors of methaemoglobin development.
*
Severe steatosis as deemed by retrieving surgeon. DBD, donation following brainstem death.