CRITÉRIOS PARA DOADOR MARGINAL DE FÍGADO: UMA REVISÃO
DOI:
https://doi.org/10.5281/zenodo.17933046Palavras-chave:
Disfunção Primária do Enxerto, Seleção do Doador, Sobrevivência de Enxerto, Transplante de FígadoResumo
Esta revisão buscou sintetizar os critérios que definem o doador marginal de fígado e avaliar suas implicações clínicas, por meio de uma análise de 35 estudos publicados entre 2010 e 2025, recuperados do PubMed, Scopus, Web of Science e SciELO. Os resultados demonstraram que a avaliação deve ser multifatorial, considerando critérios como esteatose macrovesicular (aceitável até 30%, marginal entre 30-60% e restrita acima de 60%), idade avançada do doador (>60-65 anos, com age-matching), hipernatremia (≥155 mEq/L, corrigível), tempo de isquemia fria (CIT >8-12 h, crítico para enxertos marginais), instabilidade hemodinâmica (distinguindo respostas refratária e responsiva), comorbidades metabólicas (diabetes e obesidade como fatores de risco independentes e aditivos) e infecções transmissíveis (HCV e HBV anti-HBc+, manejáveis com antivirais e profilaxia). Conclui-se que a utilização segura desses órgãos depende de uma análise integrada de riscos e benefícios, da seleção criteriosa de receptores, da adoção de estratégias mitigadoras e do suporte de ferramentas como o Donor Risk Index (DRI) e tecnologias de perfusão mecânica, consolidando essa prática como uma opção segura e necessária para expandir a disponibilidade de órgãos.
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Copyright (c) 2025 Gustavo Alves Rapassi, Kevin Lucas Barboza
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