TY - JOUR
T1 - Long-term outcomes of donation after cardiac death liver allografts from a single center
AU - Nguyen, Justin H.
AU - Bonatti, Hugo
AU - Dickson, Rolland C.
AU - Hewitt, Winston R.
AU - Grewal, Hani P.
AU - Willingham, Darrin L.
AU - Harnois, Denise M.
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.
AU - Hinder, Ronald A.
AU - Steers, Jeffery L.
AU - Hughes, Christopher B.
PY - 2009
Y1 - 2009
N2 - 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.
AB - 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.
KW - Donation after cardiac death
KW - Liver transplantation
KW - Long-term outcome
KW - Nonheartbeating donor
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U2 - 10.1111/j.1399-0012.2009.00968.x
DO - 10.1111/j.1399-0012.2009.00968.x
M3 - Article
C2 - 19220366
AN - SCOPUS:64349113411
SN - 0902-0063
VL - 23
SP - 168
EP - 173
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 2
ER -