Long-term outcomes of donation after cardiac death liver allografts from a single center.
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.
Nguyen
Justin H
JH
Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL 32224, USA. nguyen.justin@mayo.edu
Bonatti
Hugo
H
Dickson
Rolland C
RC
Hewitt
Winston R
WR
Grewal
Hani P
HP
Willingham
Darrin L
DL
Harnois
Denise M
DM
Schmitt
Timothy M
TM
Machicao
Victor I
VI
Ghabril
Marwan S
MS
Keaveny
Andrew P
AP
Aranda-Michel
Jaime
J
Satyanarayana
Raj
R
Rosser
Barry G
BG
Hinder
Ronald A
RA
Steers
Jeffery L
JL
Hughes
Christopher B
CB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003643:Death; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology*; D006085:Graft Survival; D016174:Hepacivirus / Q000472:pathogenicity; D006526:Hepatitis C / Q000821:virology; D006801:Humans; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult