title: Long-term outcomes of donation after cardiac death liver allografts from a single center.
abstract: 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.
authors.affiliation: Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL 32224, USA. nguyen.justin@mayo.edu
authors.forename: Justin H
authors.initials: JH
authors.lastname: Nguyen
authors.forename: Hugo
authors.initials: H
authors.lastname: Bonatti
authors.forename: Rolland C
authors.initials: RC
authors.lastname: Dickson
authors.forename: Winston R
authors.initials: WR
authors.lastname: Hewitt
authors.forename: Hani P
authors.initials: HP
authors.lastname: Grewal
authors.forename: Darrin L
authors.initials: DL
authors.lastname: Willingham
authors.forename: Denise M
authors.initials: DM
authors.lastname: Harnois
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Schmitt
authors.forename: Victor I
authors.initials: VI
authors.lastname: Machicao
authors.forename: Marwan S
authors.initials: MS
authors.lastname: Ghabril
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Keaveny
authors.forename: Jaime
authors.initials: J
authors.lastname: Aranda-Michel
authors.forename: Raj
authors.initials: R
authors.lastname: Satyanarayana
authors.forename: Barry G
authors.initials: BG
authors.lastname: Rosser
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Hinder
authors.forename: Jeffery L
authors.initials: JL
authors.lastname: Steers
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Hughes
mesh_terms: 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