title: Liver transplant using donors after cardiac death: a single-center approach providing outcomes comparable to donation after brain death.
abstract: OBJECTIVE
  Organ donation after cardiac death remains an available resource to meet the demand for transplant. However, concern persists that outcomes associated with donation after cardiac death liver allografts are not equivalent to those obtained with organ donation after brain death. The aim of this matched case control study was to determine if outcomes of liver transplants with donation after cardiac death donors is equivalent to outcomes with donation after brain death donors by controlling for careful donor and recipient selection, surgical technique, and preservation solution.
  
  
  METHODS
  A retrospective, matched case control study of adult liver transplant recipients at the University of Tennessee/Methodist University Hospital Transplant Institute, Memphis, Tennessee was performed. Thirty-eight donation after cardiac death recipients were matched 1:2, with 76 donation after brain death recipients by recipient age, recipient laboratory Model for End Stage Liver Disease score, and donor age to form the 2 groups. A comprehensive approach that controlled for careful donor and recipient matching, surgical technique, and preservation solution was used to minimize warm ischemia time, cold ischemia time, and ischemia-reperfusion injury.
  
  
  RESULTS
  Patient and graft survival rates were similar in both groups at 1 and 3 years (P = .444 and P = .295). There was no statistically significant difference in primary nonfunction, vascular complications, or biliary complications. In particular, there was no statistically significant difference in ischemic-type diffuse intrahepatic strictures (P = .107).
  
  
  CONCLUSIONS
  These findings provide further evidence that excellent patient and graft survival rates expected with liver transplants using organ donation after brain death donors can be achieved with organ donation after cardiac death donors without statistically higher rates of morbidity or mortality when a comprehensive approach that controls for careful donor and recipient matching, surgical technique, and preservation solution is used.
authors.affiliation: Department of Transplantation, University of Tennessee/Methodist University Hospital Transplant Institute, Memphis, TN 38104, USA. jvanatta@uthsc.edu
authors.forename: Jason M
authors.initials: JM
authors.lastname: Vanatta
authors.forename: Amanda G
authors.initials: AG
authors.lastname: Dean
authors.forename: Donna K
authors.initials: DK
authors.lastname: Hathaway
authors.forename: Satheesh
authors.initials: S
authors.lastname: Nair
authors.forename: Kian A
authors.initials: KA
authors.lastname: Modanlou
authors.forename: Luis
authors.initials: L
authors.lastname: Campos
authors.forename: Nosratollah
authors.initials: N
authors.lastname: Nezakatgoo
authors.forename: Sanjaya K
authors.initials: SK
authors.lastname: Satapathy
authors.forename: James D
authors.initials: JD
authors.lastname: Eason
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D001926:Brain Death; D003643:Death; D005260:Female; D006650:Histocompatibility Testing; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D019188:Organ Preservation Solutions; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013714:Tennessee / Q000453:epidemiology; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D019188:Organ Preservation Solutions