title: Applicability and results of Maastricht type 2 donation after cardiac death liver transplantation.
abstract: Maastricht type 2 donation after cardiac death (DCD) donors suffer sudden and unexpected cardiac arrest, typically outside the hospital; they have significant potential to expand the donor pool. Herein, we analyze the results of transplanted livers and all potential donors treated under our type 2 DCD protocol. Cardiac arrest was witnessed; potential donors arrived at the hospital after attempts at resuscitation had failed. Death was declared based on the absence of cardiorespiratory activity during a 5-min no-touch period. Femoral vessels were cannulated to establish normothermic extracorporeal membrane oxygenation, which was maintained until organ recovery. From April 2002 to December 2010, there were 400 potential donors; 34 liver transplants were performed (9%). Among recipients, median age, model for end-stage liver disease and cold and reperfusion warm ischemic times were 55 years (49-60), 19 (14-21) and 380 (325-430) and 30 min (26-35), respectively. Overall, 236 (59%) and 130 (32%) livers were turned down due to absolute and relative contraindications to donate, respectively. One-year recipient and graft survivals were 82% and 70%, respectively (median follow-up 24 months). The applicability of type 2 DCD liver transplant was <10%; however, with better preservation technology and expanded transplant criteria, we may be able to improve this figure significantly.
authors: Department of Surgery, Liver Transplant Unit, Hospital Clínic, CIBERehd, University of Barcelona, Barcelona, Spain. cfonde@clinic.ub.es
authors: C
authors: C
authors: Fondevila
authors: A J
authors: AJ
authors: Hessheimer
authors: E
authors: E
authors: Flores
authors: A
authors: A
authors: Ruiz
authors: N
authors: N
authors: Mestres
authors: D
authors: D
authors: Calatayud
authors: D
authors: D
authors: Paredes
authors: C
authors: C
authors: Rodríguez
authors: J
authors: J
authors: Fuster
authors: M
authors: M
authors: Navasa
authors: A
authors: A
authors: Rimola
authors: P
authors: P
authors: Taurá
authors: J C
authors: JC
authors: García-Valdecasas
mesh_terms: D000328:Adult; D003643:Death; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors