title: Liver transplantation from an uncontrolled non-heart-beating donor maintained on extracorporeal membrane oxygenation.
abstract: Liver transplantation, a definitive treatment for end-stage liver disease, has achieved excellent results. However, potential recipients on the waiting list outnumber donors. To expand the donor pool, marginal grafts from older donors, steatotic livers, and non-heart-beating liver donors (NHBD) have been used for transplantation. Reducing the warm ischemia time of NHBD is the critical factor in organs preservation. Liver transplantation using grafts from NHBD have been reported to display a high incidence of primary graft nonfunction and biliary complications. The authors report a liver graft donor who was maintained on extracorporeal membrane oxygenation (ECMO) after successful cardiopulmonary resuscitation. Core body temperature was 5 degrees C. Procurement of the liver using a rapid flush technique was performed 4 hours after instituting ECMO. Graft function recovered fully after transplantation. In conclusion, ECMO may be used to reduce warm ischemia time in liver grafts obtained from uncontrolled NHBD, thereby increasing graft salvage rates.
authors.affiliation: Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan.
authors.forename: C-C
authors.initials: CC
authors.lastname: Wang
authors.forename: S-H
authors.initials: SH
authors.lastname: Wang
authors.forename: C-C
authors.initials: CC
authors.lastname: Lin
authors.forename: Y-W
authors.initials: YW
authors.lastname: Liu
authors.forename: C-C
authors.initials: CC
authors.lastname: Yong
authors.forename: C-H
authors.initials: CH
authors.lastname: Yang
authors.forename: K-C
authors.initials: KC
authors.lastname: Huang
authors.forename: T-S
authors.initials: TS
authors.lastname: Lin
authors.forename: B
authors.initials: B
authors.lastname: Jawan
authors.forename: Y-F
authors.initials: YF
authors.lastname: Cheng
authors.forename: H-L
authors.initials: HL
authors.lastname: Eng
authors.forename: A M
authors.initials: AM
authors.lastname: Concejero
authors.forename: C-L
authors.initials: CL
authors.lastname: Chen
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D001930:Brain Injuries; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006323:Heart Arrest; D006498:Hepatectomy; D006509:Hepatitis B / Q000601:surgery; D006801:Humans; D017093:Liver Failure / Q000601:surgery / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome