Research Group

  • Dr Richard S. Mangus, Principal Investigator
  • Ass. Prof. Joseph A.Tector, Research Associate
  • Prof. Daniel Raftery, Research Associate


  • Indiana University, Indianapolis, USA


  • Use of Extended Criteria Donor Organs in Liver Transplantation

Worldwide there is a growing demand for transplant organs. Current mechanisms for meeting this need are inadequate. One approach to increase organ availability is the use of living donors, but this imparts a significant risk upon healthy persons and results in a graft that carries a risk similar to a liver from a non-heart beating donor. Use of extended criteria donor (ECD) livers affords no additional risk to the general population and utilizes organs already available. Ten percent of U.S. livers donated are ultimately not transplanted (~600 annually). Indiana University (IU) has made important progress over the last 5 years to expand the donor pool through the aggressive use of ECD livers. Between 2000 and 2006, use of ECD livers at IU has increased from <10% up to >80%. This has increased annual transplants from 40 to 175, and decreased median wait time from 31 months to one month, without use of living donors and with improved 1-year survival. Continued clinical, histological and biochemical analysis of these donor organs is necessary to identify optimal donor−recipient pairings. Statistical analysis of clinical data shows increased use of livers from donors with: old age, severe obesity, hypernatremia, hepatitis C, HTLV, hepatitis B antibody, cardiac death, organ trauma, alcoholism, previous cancer, and prolonged ICU stay. Continued expansion of the IU donor tissue bank will provide a rich source of ECD donor liver tissue for analysis. Initial use of metabolomic technology for the analysis of these donor livers has been promising in identifying distinct patterns of metabolic activity for organs with increasing ischemia time and from different donor types. Future research will expand donor analysis to proteomic technology with the hope of identifying biomarkers predictive of successful organ utilization and perhaps lead to therapies to improve organ function.

Final Report