Severe Atherosclerosis in Donor Liver Vasculature: An Illustrative Case Report and Review of the Literature

Ayokunle S. Olowofela, Oscar K. Serrano, Raja Kandaswamy

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


As the scarcity of transplantable organs continues to increase, juxtaposed with an aging donor population, transplant surgeons are increasingly confronted with marginal organ offers. The presence of atherosclerosis in the donor allograft has been shown to compromise the vascular integrity and predispose to vascular complications in the transplanted liver. Here, we present a case of 54-year-old brain-dead donor who was discovered to have a severely diseased aorta during organ recovery. Pathologic evaluation revealed severe atherosclerosis with calcifications. Because there was no evidence of donor graft dysfunction, we elected to proceed with implantation, although thoughtful consideration was given to aborting the procedure. The donor hepatic artery was resected from the bifurcation of the splenic artery and the common hepatic artery until no further gross atheromas were evident; this segment was then anastomosed with the recipient proper hepatic artery. The recipient is doing well 6 months after transplant without any significant adverse postoperative events. The presence of severe atherosclerosis should not discourage the use of an otherwise adequate graft. Novel newer preservation techniques, such as normothermic perfusion, may enable functional graft evaluation and can increase the utilization of marginal grafts.

Original languageEnglish (US)
Pages (from-to)1134-1136
Number of pages3
JournalExperimental and Clinical Transplantation
Issue number12
StatePublished - Dec 2022

Bibliographical note

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© Başkent University 2022 Printed in Turkey. All Rights Reserved.


  • Deceased donor organs
  • Extended-criteria donor
  • Liver transplant
  • Older donor


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