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ORIGINAL RESEARCH article

Front. Transplant.
Sec. Abdominal Transplantation
Volume 3 - 2024 | doi: 10.3389/frtra.2024.1441928

THE CARBON FOOTPRINT AND ENERGY CONSUMPTION OF LIVER TRANSPLANTATION

Provisionally accepted
Paolo De Simone Paolo De Simone 1*Quirino Lai Quirino Lai 2Juri Ducci Juri Ducci 3Daniela Campani Daniela Campani 1Giandomenico Biancofiore Giandomenico Biancofiore 1
  • 1 University of Pisa, Pisa, Italy
  • 2 Sapienza University of Rome, Rome, Lazio, Italy
  • 3 Hepatobiliary surgery and liver transplantation, University of Pisa Medical School Hospital, Pisa, Tuscany, Italy

The final, formatted version of the article will be published soon.

    Background and Aims: There is growing interest in the environmental impact of surgical procedures, yet more information is needed specifically regarding liver transplantation. This study aims to quantify the total greenhouse gas emissions, or carbon footprint, associated with adult whole-size liver transplantation from donors after brain death, including the relevant back-table graft preparation.Methods: The carbon footprint was calculated retrospectively using a bottom-up approach.This approach sums the volumes of energy consumption (kWh), volatile anesthetics (mL), solid waste (kg), and units of blood products transfused for each transplant. These consumption values were converted using validated conversion factors to the equivalent mass of carbon dioxide released into the environment (kg CO2e).Results: A total of 147 patients with a mean age of 55 years (male, 78.9%) who underwent liver transplants between 2021 and 2022 were analyzed, resulting in 45.5 tons CO2e. The mean (SD) carbon footprint for each procedure was 309.8 (33.2) kg CO2e [95% CI: 304.4; 315.3]. Total energy power consumption was 96.5 MW, contributing 65.4% of greenhouse emissions (29.8 tons CO2e), while volatile anesthetics, solid waste, and blood product transfusions contributed 8.0% (3.64 tons CO2e), 5.9% (2.7 tons CO2e), and 20.6% (9.4 tons CO2e), respectively. The duration of surgery (t=29.0; p<0.001), transfused red blood cells (t=13.1; p<0.001), fresh frozen plasma (t=11.1; p<0.001), platelets (t=8.9; p<0.001), and the use of an extracorporeal pump machine (t=3.6; p<0.001) had the greatest effects on greenhouse gas emissions.Conclusions: Liver transplantation requires significant energy and is associated with considerable greenhouse gas emissions, particularly during longer procedures. Transplant clinicians, hospital administrators, policymakers, and patients should be aware of the environmental impact of liver transplantation and collaborate to adopt sustainable energy practices.

    Keywords: Liver Transplantation, Carbon Footprint, Greenhouse gas emissions, CO2, pollution, Global Warming, energy consumption PDS, QL

    Received: 31 May 2024; Accepted: 12 Dec 2024.

    Copyright: © 2024 De Simone, Lai, Ducci, Campani and Biancofiore. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Paolo De Simone, University of Pisa, Pisa, Italy

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