Liver transplantation using controlled donation after cardiac death donors: An analysis of a large single-center experience

Hani P. Grewal, Darrin L. Willingham, Justin H Nguyen, Winston R. Hewitt, Bucin C. Taner, Danielle Cornell, Barry G. Rosser, Andrew P. Keaveny, Jamie Aranda-Michel, Raj Satyanarayana, Denise Harnois, Rolland Dickson, David J. Kramer, Christopher B. Hughes

Research output: Contribution to journalArticle

130 Citations (Scopus)

Abstract

The use of donation after cardiac death (DCD) donors may provide a valuable source of organs for liver transplantation. Concerns regarding primary nonfunction (PNF) and intrahepatic biliary stricture (IHBSs) have limited the enthusiasm for their use. A retrospective analysis of 1436 consecutive deceased donor liver transplants performed between December 1998 and October 2006 was conducted. These included 108 DCD liver transplants, which were compared to 1328 transplants performed with organs from donors meeting the criteria for donation after brain death (DBD). The median follow-up was 48 months. The 1-, 3-, and 5-year patient survival and graft survival for DCD donors were 91.5%, 88.1%, and 88.1% and 79.3%, 74.5%, and 71.0%, respectively. The 1-, 3-, and 5-year patient survival and graft survival for DBD donors were 87.3%, 81.1%, and 77.2% and 81.6%, 74.7%, and 69.1%, respectively. Patient survival and graft survival were not significantly different between DCD donors less than 60 years old, DCD donors greater than 60 years old, and DBD donors. Causes of graft loss included IHBSs (n = 9), PNF (n = 4), recurrent hepatitis C virus (n = 4), hepatic artery thrombosis (n = 1), rejection (n = 2), and patient death (n = 13). Contrary to previously published data, excellent long-term patient survival and graft survival can be obtained with DCD allografts, and in our experience, they are equivalent to those obtained from DBD allografts.

Original languageEnglish (US)
Pages (from-to)1028-1035
Number of pages8
JournalLiver Transplantation
Volume15
Issue number9
DOIs
StatePublished - 2009

Fingerprint

Liver Transplantation
Tissue Donors
Brain Death
Graft Survival
Transplants
Survival
Allografts
Pathologic Constriction
Liver
Hepatic Artery
Organ Transplantation
Hepacivirus
Thrombosis

ASJC Scopus subject areas

  • Surgery
  • Transplantation
  • Hepatology

Cite this

Liver transplantation using controlled donation after cardiac death donors : An analysis of a large single-center experience. / Grewal, Hani P.; Willingham, Darrin L.; Nguyen, Justin H; Hewitt, Winston R.; Taner, Bucin C.; Cornell, Danielle; Rosser, Barry G.; Keaveny, Andrew P.; Aranda-Michel, Jamie; Satyanarayana, Raj; Harnois, Denise; Dickson, Rolland; Kramer, David J.; Hughes, Christopher B.

In: Liver Transplantation, Vol. 15, No. 9, 2009, p. 1028-1035.

Research output: Contribution to journalArticle

Grewal, HP, Willingham, DL, Nguyen, JH, Hewitt, WR, Taner, BC, Cornell, D, Rosser, BG, Keaveny, AP, Aranda-Michel, J, Satyanarayana, R, Harnois, D, Dickson, R, Kramer, DJ & Hughes, CB 2009, 'Liver transplantation using controlled donation after cardiac death donors: An analysis of a large single-center experience', Liver Transplantation, vol. 15, no. 9, pp. 1028-1035. https://doi.org/10.1002/lt.21811
Grewal, Hani P. ; Willingham, Darrin L. ; Nguyen, Justin H ; Hewitt, Winston R. ; Taner, Bucin C. ; Cornell, Danielle ; Rosser, Barry G. ; Keaveny, Andrew P. ; Aranda-Michel, Jamie ; Satyanarayana, Raj ; Harnois, Denise ; Dickson, Rolland ; Kramer, David J. ; Hughes, Christopher B. / Liver transplantation using controlled donation after cardiac death donors : An analysis of a large single-center experience. In: Liver Transplantation. 2009 ; Vol. 15, No. 9. pp. 1028-1035.
@article{f0bf63a292bf425381e562bb9532818f,
title = "Liver transplantation using controlled donation after cardiac death donors: An analysis of a large single-center experience",
abstract = "The use of donation after cardiac death (DCD) donors may provide a valuable source of organs for liver transplantation. Concerns regarding primary nonfunction (PNF) and intrahepatic biliary stricture (IHBSs) have limited the enthusiasm for their use. A retrospective analysis of 1436 consecutive deceased donor liver transplants performed between December 1998 and October 2006 was conducted. These included 108 DCD liver transplants, which were compared to 1328 transplants performed with organs from donors meeting the criteria for donation after brain death (DBD). The median follow-up was 48 months. The 1-, 3-, and 5-year patient survival and graft survival for DCD donors were 91.5{\%}, 88.1{\%}, and 88.1{\%} and 79.3{\%}, 74.5{\%}, and 71.0{\%}, respectively. The 1-, 3-, and 5-year patient survival and graft survival for DBD donors were 87.3{\%}, 81.1{\%}, and 77.2{\%} and 81.6{\%}, 74.7{\%}, and 69.1{\%}, respectively. Patient survival and graft survival were not significantly different between DCD donors less than 60 years old, DCD donors greater than 60 years old, and DBD donors. Causes of graft loss included IHBSs (n = 9), PNF (n = 4), recurrent hepatitis C virus (n = 4), hepatic artery thrombosis (n = 1), rejection (n = 2), and patient death (n = 13). Contrary to previously published data, excellent long-term patient survival and graft survival can be obtained with DCD allografts, and in our experience, they are equivalent to those obtained from DBD allografts.",
author = "Grewal, {Hani P.} and Willingham, {Darrin L.} and Nguyen, {Justin H} and Hewitt, {Winston R.} and Taner, {Bucin C.} and Danielle Cornell and Rosser, {Barry G.} and Keaveny, {Andrew P.} and Jamie Aranda-Michel and Raj Satyanarayana and Denise Harnois and Rolland Dickson and Kramer, {David J.} and Hughes, {Christopher B.}",
year = "2009",
doi = "10.1002/lt.21811",
language = "English (US)",
volume = "15",
pages = "1028--1035",
journal = "Liver Transplantation",
issn = "1527-6465",
publisher = "John Wiley and Sons Ltd",
number = "9",

}

TY - JOUR

T1 - Liver transplantation using controlled donation after cardiac death donors

T2 - An analysis of a large single-center experience

AU - Grewal, Hani P.

AU - Willingham, Darrin L.

AU - Nguyen, Justin H

AU - Hewitt, Winston R.

AU - Taner, Bucin C.

AU - Cornell, Danielle

AU - Rosser, Barry G.

AU - Keaveny, Andrew P.

AU - Aranda-Michel, Jamie

AU - Satyanarayana, Raj

AU - Harnois, Denise

AU - Dickson, Rolland

AU - Kramer, David J.

AU - Hughes, Christopher B.

PY - 2009

Y1 - 2009

N2 - The use of donation after cardiac death (DCD) donors may provide a valuable source of organs for liver transplantation. Concerns regarding primary nonfunction (PNF) and intrahepatic biliary stricture (IHBSs) have limited the enthusiasm for their use. A retrospective analysis of 1436 consecutive deceased donor liver transplants performed between December 1998 and October 2006 was conducted. These included 108 DCD liver transplants, which were compared to 1328 transplants performed with organs from donors meeting the criteria for donation after brain death (DBD). The median follow-up was 48 months. The 1-, 3-, and 5-year patient survival and graft survival for DCD donors were 91.5%, 88.1%, and 88.1% and 79.3%, 74.5%, and 71.0%, respectively. The 1-, 3-, and 5-year patient survival and graft survival for DBD donors were 87.3%, 81.1%, and 77.2% and 81.6%, 74.7%, and 69.1%, respectively. Patient survival and graft survival were not significantly different between DCD donors less than 60 years old, DCD donors greater than 60 years old, and DBD donors. Causes of graft loss included IHBSs (n = 9), PNF (n = 4), recurrent hepatitis C virus (n = 4), hepatic artery thrombosis (n = 1), rejection (n = 2), and patient death (n = 13). Contrary to previously published data, excellent long-term patient survival and graft survival can be obtained with DCD allografts, and in our experience, they are equivalent to those obtained from DBD allografts.

AB - The use of donation after cardiac death (DCD) donors may provide a valuable source of organs for liver transplantation. Concerns regarding primary nonfunction (PNF) and intrahepatic biliary stricture (IHBSs) have limited the enthusiasm for their use. A retrospective analysis of 1436 consecutive deceased donor liver transplants performed between December 1998 and October 2006 was conducted. These included 108 DCD liver transplants, which were compared to 1328 transplants performed with organs from donors meeting the criteria for donation after brain death (DBD). The median follow-up was 48 months. The 1-, 3-, and 5-year patient survival and graft survival for DCD donors were 91.5%, 88.1%, and 88.1% and 79.3%, 74.5%, and 71.0%, respectively. The 1-, 3-, and 5-year patient survival and graft survival for DBD donors were 87.3%, 81.1%, and 77.2% and 81.6%, 74.7%, and 69.1%, respectively. Patient survival and graft survival were not significantly different between DCD donors less than 60 years old, DCD donors greater than 60 years old, and DBD donors. Causes of graft loss included IHBSs (n = 9), PNF (n = 4), recurrent hepatitis C virus (n = 4), hepatic artery thrombosis (n = 1), rejection (n = 2), and patient death (n = 13). Contrary to previously published data, excellent long-term patient survival and graft survival can be obtained with DCD allografts, and in our experience, they are equivalent to those obtained from DBD allografts.

UR - http://www.scopus.com/inward/record.url?scp=70350543337&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70350543337&partnerID=8YFLogxK

U2 - 10.1002/lt.21811

DO - 10.1002/lt.21811

M3 - Article

C2 - 19718636

AN - SCOPUS:70350543337

VL - 15

SP - 1028

EP - 1035

JO - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 9

ER -