Nonfunctioning graft (NFG) is a serious complication of liver transplantation and its treatment is only retransplantation. With shortage of available deceased donors, the patients are most often condemned to death.
Methods: From May 1993 to July 2006, 251 OLTs were performed on 249 recipients. In a prospective design, all data regarding age and sex of donors and recipients, ischemic time, causes of death in donors, shipping of harvested graft and its function were collected. Living donor liver transplantation was excluded from this study.
Results: 231 cases (55% male, 45% female) with mean age of 36 years old (3-61years) had graft form deceased donors. Main donor sources (82% male and 18% female) were from Shiraz (125), Tehran (63), Mashad (17) and Isfahan (16) with mean ischemic time of 6.3, 11, 11.30 and 10 hours, respectively. Mean age of donor was 28 years. 61% of donors had less than 30 years. 96% had vehicle accident. Nine were older than 50 years old (3.8%). Six donors had short ischemic time and 3 had long ischemic time. In our recipients, five cases had NFG (2.1%). In 3 of them, donor was older than 50 years old. All NFGs had ischemic time more than 10 hours. Post operative AST and ALT values were more than 1600 IU in NFGs. Two of 5 NFGs had donors younger than 50 years old; however, they were harvested by a trained but uncertified surgeon. Transplantation team was the same in all NFGs. All patients died on day 3 or 4.Conclusion: The most important cause of death in donors is vehicle accident. Donors are not old and NFG is uncommon. Old donors (>50 yr) with prolonged ischemic time (>10 h) and probably harvesting by inexperienced surgeon are risk factors for NFG.