Current Topics in TransplantationOrgan procurement/allocationPrimum Non Nocere: Organ Donation After Electrocution and Transplantation of Electricity-Damaged Livers: Report of 2 Cases

- Report of 2 liver transplantation cases after brain death donation (DBD) with sizeable hepatic electrical injury and a multiorgan DBD after fatal electrical injury
- Report of electrical injury to the liver secondary to defibrillation during DBD organ procurement
- Electrocution is not a contraindication for DBD organ donation; electricity-damaged DBD liver allografts may remain transplantable after careful assessment
- Inappropriate positioning of external defibrillation paddles during organ procurement surgery can cause electrical injury to the liver

Liver transplantation remains the treatment of choice for patients with end-stage liver disease. However, allograft availability continues to be a problem, and extending the criteria for organ acceptance is key. Deceased donors after electrical accidents, as well as electricity-traumatized allografts, are not common but should be considered suitable. This study describes 2 cases of heart-beating organ donors with electrical injury to the liver. In 1 case, the electric shock was the cause of death; in the second case, the injury was caused by defibrillation at organ procurement. Both allografts had sustained sizeable electrical injury, and both resulted in excellent early posttransplant outcomes. These cases demonstrate that electrocution is not a contraindication to donation and that electricity-traumatized allografts may remain transplantable after careful assessment. Education of all staff in the management of such donors can optimize utility of such allografts.