Long-term outcomes of donation after cardiac death liver allografts from a single center

Justin H Nguyen, Hugo Bonatti, Rolland Dickson, Winston R. Hewitt, Hani P. Grewal, Darrin L. Willingham, Denise Harnois, Timothy M. Schmitt, Victor I. Machicao, Marwan S. Ghabril, Andrew P. Keaveny, Jaime Aranda-Michel, Raj Satyanarayana, Barry G. Rosser, Ronald A. Hinder, Jeffery L. Steers, Christopher B. Hughes

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Organ shortage continues to be a major challenge in transplantation. Recent experience with controlled non-heart-beating or donation after cardiac death (DCD) are encouraging. However, long-term outcomes of DCD liver allografts are limited. In this study, we present outcomes of 19 DCD liver allografts with follow-up >4.5 years. During 1998-2001, 19 (4.1%) liver transplants (LT) with DCD allografts were performed at our center. Conventional heart-beating donors included 234 standard criteria donors (SCD) and 214 extended criteria donors (ECD). We found that DCD allografts had equivalent rates of primary non-function and biliary complications as compared with SCD and ECD. The overall one-, two-, and five-yr DCD graft and patient survival was 73.7%, 68.4%, and 63.2%, and 89.5%, 89.5%, and 89.5%, respectively. DCD graft survival was similar to graft survival of SCD and ECD in non hepatitis C virus (HCV) recipients (p>0.370). In contrast, DCD graft survival was significantly reduced in HCV recipients (p=0.007). In conclusion, DCD liver allografts are durable and have acceptable long-term outcomes. Further research is required to assess the impact of HCV on DCD allograft survival.

Original languageEnglish (US)
Pages (from-to)168-173
Number of pages6
JournalClinical Transplantation
Volume23
Issue number2
DOIs
StatePublished - 2009

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Allografts
Liver
Tissue Donors
Graft Survival
Hepacivirus
Transplantation
Transplants
Research

Keywords

  • Donation after cardiac death
  • Liver transplantation
  • Long-term outcome
  • Nonheartbeating donor

ASJC Scopus subject areas

  • Transplantation

Cite this

Long-term outcomes of donation after cardiac death liver allografts from a single center. / Nguyen, Justin H; Bonatti, Hugo; Dickson, Rolland; Hewitt, Winston R.; Grewal, Hani P.; Willingham, Darrin L.; Harnois, Denise; Schmitt, Timothy M.; Machicao, Victor I.; Ghabril, Marwan S.; Keaveny, Andrew P.; Aranda-Michel, Jaime; Satyanarayana, Raj; Rosser, Barry G.; Hinder, Ronald A.; Steers, Jeffery L.; Hughes, Christopher B.

In: Clinical Transplantation, Vol. 23, No. 2, 2009, p. 168-173.

Research output: Contribution to journalArticle

Nguyen, JH, Bonatti, H, Dickson, R, Hewitt, WR, Grewal, HP, Willingham, DL, Harnois, D, Schmitt, TM, Machicao, VI, Ghabril, MS, Keaveny, AP, Aranda-Michel, J, Satyanarayana, R, Rosser, BG, Hinder, RA, Steers, JL & Hughes, CB 2009, 'Long-term outcomes of donation after cardiac death liver allografts from a single center', Clinical Transplantation, vol. 23, no. 2, pp. 168-173. https://doi.org/10.1111/j.1399-0012.2009.00968.x
Nguyen, Justin H ; Bonatti, Hugo ; Dickson, Rolland ; Hewitt, Winston R. ; Grewal, Hani P. ; Willingham, Darrin L. ; Harnois, Denise ; Schmitt, Timothy M. ; Machicao, Victor I. ; Ghabril, Marwan S. ; Keaveny, Andrew P. ; Aranda-Michel, Jaime ; Satyanarayana, Raj ; Rosser, Barry G. ; Hinder, Ronald A. ; Steers, Jeffery L. ; Hughes, Christopher B. / Long-term outcomes of donation after cardiac death liver allografts from a single center. In: Clinical Transplantation. 2009 ; Vol. 23, No. 2. pp. 168-173.
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abstract = "Organ shortage continues to be a major challenge in transplantation. Recent experience with controlled non-heart-beating or donation after cardiac death (DCD) are encouraging. However, long-term outcomes of DCD liver allografts are limited. In this study, we present outcomes of 19 DCD liver allografts with follow-up >4.5 years. During 1998-2001, 19 (4.1{\%}) liver transplants (LT) with DCD allografts were performed at our center. Conventional heart-beating donors included 234 standard criteria donors (SCD) and 214 extended criteria donors (ECD). We found that DCD allografts had equivalent rates of primary non-function and biliary complications as compared with SCD and ECD. The overall one-, two-, and five-yr DCD graft and patient survival was 73.7{\%}, 68.4{\%}, and 63.2{\%}, and 89.5{\%}, 89.5{\%}, and 89.5{\%}, respectively. DCD graft survival was similar to graft survival of SCD and ECD in non hepatitis C virus (HCV) recipients (p>0.370). In contrast, DCD graft survival was significantly reduced in HCV recipients (p=0.007). In conclusion, DCD liver allografts are durable and have acceptable long-term outcomes. Further research is required to assess the impact of HCV on DCD allograft survival.",
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AU - Willingham, Darrin L.

AU - Harnois, Denise

AU - Schmitt, Timothy M.

AU - Machicao, Victor I.

AU - Ghabril, Marwan S.

AU - Keaveny, Andrew P.

AU - Aranda-Michel, Jaime

AU - Satyanarayana, Raj

AU - Rosser, Barry G.

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