Survival of recipients of livers from donation after circulatory death who are relisted and undergo retransplant for graft failure

A. M. Allen, W. R. Kim, H. Xiong, J. Liu, P. G. Stock, J. R. Lake, S. Chinnakotla, J. J. Snyder, A. K. Israni, B. L. Kasiske

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Use of grafts from donation after circulatory death (DCD) as a strategy to increase the pool of transplantable livers has been limited due to poorer recipient outcomes compared with donation after brain death (DBD). We examined outcomes of recipients of failed DCD grafts who were selected for relisting with regard to waitlist mortality and patient and graft survival after retransplant. From the Scientific Registry of Transplant Recipients database, we identified 1820 adults who underwent first deceased donor liver transplant January 1, 2004 to June 30, 2011, and were relisted due to graft failure; 12.7% were DCD recipients. Compared with DBD recipients, DCD recipients had better waitlist survival (90-day mortality: 8%, DCD recipients; 14-21%, DBD recipients). Of 950 retransplant patients, 14.5% were prior DCD recipients. Graft survival after second liver transplant was similar for prior DCD (28% graft failure within 1 year) and DBD recipients (30%). Patient survival was slightly better for prior DCD (25% death within 1 year) than DBD recipients (28%). Despite higher overall graft failure and morbidity rates, survival of prior DCD recipients who were selected for relisting and retransplant was not worse than survival of DBD recipients. This analysis of recipients of livers from donation after circulatory death donors who experienced graft failure and were selected to be relisted and undergo retransplant shows that mortality in these patients while waiting for and after undergoing retransplant was not higher compared with mortality in recipients of livers from brain dead donors. See editorial by Skaro et al on page 991.

Original languageEnglish (US)
Pages (from-to)1120-1128
Number of pages9
JournalAmerican Journal of Transplantation
Volume14
Issue number5
DOIs
StatePublished - May 2014

Keywords

  • Graft survival
  • liver transplantation
  • outcomes
  • patient survival
  • waitlist mortality

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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    Allen, A. M., Kim, W. R., Xiong, H., Liu, J., Stock, P. G., Lake, J. R., Chinnakotla, S., Snyder, J. J., Israni, A. K., & Kasiske, B. L. (2014). Survival of recipients of livers from donation after circulatory death who are relisted and undergo retransplant for graft failure. American Journal of Transplantation, 14(5), 1120-1128. https://doi.org/10.1111/ajt.12700