Liver transplantation from maastricht category 2 non-heart-beating donors: a source to increase the donor pool?
BACKGROUND
The demand for liver transplantation has increasingly exceeded the supply of cadaver donor organs. Non-heart-beating donors (NHBDs) may be an alternative to increase the cadaver donor pool. The outcome of 20 liver transplants from Maastricht category 2 NHBD was compared with that of 40 liver transplants from heart-beating donors (HBDs). After unsuccessful cardiopulmonary resuscitation (CPR), cardiopulmonary support with simultaneous application of chest and abdominal compression (CPS; n = 6) or cardiopulmonary bypass (CPB; n = 14) was used to maintain the donors.


RESULTS
At a minimum follow-up of 2 years, actuarial patient and graft survival rates with livers from Maastricht category 2 NHBD were 80% and 55%, respectively. Transplantation of organs from these donors was associated with a significantly higher incidence of primary nonfunction, biliary complications, and more severe initial liver dysfunction compared with organs from HBDs. The graft survival rates was 83% for livers from NHBDs preserved with CPS and 42% in those maintained with CPB.
Otero
A
A
Liver Transplant Unit, Hospital Juan Canalejo, La Coruña, La Coruña, Spain. javi-18@canalejo.org
Gómez-Gutiérrez
M
M
Suárez
F
F
Arnal
F
F
Fernández-García
A
A
Aguirrezabalaga
J
J
García-Buitrón
J
J
Alvarez
J
J
Máñez
R
R
D000293:Adolescent; D000328:Adult; D016887:Cardiopulmonary Resuscitation; D005500:Follow-Up Studies; D006085:Graft Survival; D006323:Heart Arrest; D006339:Heart Rate; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008099:Liver / Q000166:cytology / Q000473:pathology; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors / Q000145:classification* / Q000600:supply & distribution; D020858:Tissue and Organ Harvesting / Q000379:methods