Liver transplantation from donation after cardiac death donors: initial Belgian experience 2003-2007.
The Belgian experience with donation after cardiac death (DCD) liver transplantation (LT) was retrospectively reviewed, particularly evaluating patient and graft survivals, and biliary complications. From 2003 to 2007, 58 DCD-LT were performed in Belgium. Mean procurement total warm ischemia time was 25 +/- 2 min (mean +/- SEM). Mean cold ischemia time was 451 +/- 18 min. Mean follow-up was 23 +/- 2.2 months. Post-transplant peak aspartate aminotransminases was 2241 +/- 338 UI/l. Patient survivals at 1 month, 1 and 3 years, were 91.3%, 83.3% and 66.9% respectively. Graft survivals at 1 month, 1 and 3 years, were 84.4%, 72.4% and 48.8% respectively. Two patients (3.4%) developed primary nonfunction. Regarding the biliary complications, seven grafts (12%) were lost because of intrahepatic cholangiopathy, and 12 other patients (20.6%) developed bile duct stenoses requiring endoscopic and/or surgical management. The rate of symptomatic ischemic biliary lesions for grafts surviving more than 3 months was 38% (19/50). Although DCD organ donors may be a source of viable liver grafts, results were inferior to those obtained with donation after brain death LT in this series. Prognostic criteria have to be developed to improve results of DCD-LT.
Detry
Olivier
O
Department of Abdominal Surgery and Transplantation, CHU de Liège, University of Liège, Liège, Belgium. oli.detry@chu.ulg.ac.be
Donckier
Vincent
V
Lucidi
Valerio
V
Ysebaert
Dirk
D
Chapelle
Thiery
T
Lerut
Jan
J
Ciccarelli
Olga
O
Pirenne
Jacques
J
Monbaliu
Diethard
D
De Roover
Arnaud
A
Honoré
Pierre
P
Rogiers
Xavier
X
De Hemptinne
Bernard
B
Troisi
Roberto
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D001530:Belgium / Q000453:epidemiology; D001926:Brain Death; D002423:Cause of Death; D002648:Child; D050377:Cold Ischemia; D003643:Death; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data; D016896:Treatment Outcome