title: Liver Transplantation Using Donation After Brain and Cardiac Death: A Single-Center Experience in China.
abstract: BACKGROUND
  Liver transplantation (LTx) using donation after brain and cardiac death (DBCD) has increased steadily in China. The aims of this study were to evaluate the outcomes of DBCD LTx and to assess its feasibility to expand the donor pool.
  
  
  METHODS
  We retrospectively analyzed the clinical characteristics of DBCD donors and recipients, survival of allografts and recipients, and prognostic factors in DBCD LTx recipients from March 2010 to December 2014 in our institution.
  
  
  RESULTS
  DBCD LTx (n = 102) were performed in our institution during the research period, and the successful donation rate was 26.0%. Mean warm ischemia time and cold ischemia time were 14.39 minutes and 5.29 hours, respectively. The overall and biliary complication rates were 45.1% and 16.7%, respectively. Donor age (P = .043), intra-operative blood loss (P = .048), and operation time (P = .045) were significantly different between the complication and non-complication groups. The 1-, 2-, and 3-year survival rates of patients and grafts were 88.0%, 84.6%, 84.6%, and 85.7%, 78.6%, and 78.6%, respectively. The 1- and 2-year overall survival rates of hepatocellular carcinoma patients were 91.9% and 80.5%, respectively whereas the recurrence-free survival rates were 84.9% and 77.2%, respectively. The patient and graft survival rates were not statistically different between the <55-year and ≥55 year groups, but complication rate was higher in the older group than in the younger group (P = .003).
  
  
  CONCLUSIONS
  The outcome of DBCD LTx is favorable in our institution, with careful donor and recipient selection and careful peri-operative management. DBCD is an optimized solution for organ shortage in today's China.
authors: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, PR China.
authors: X
authors: X
authors: Liu
authors: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, PR China.
authors: B
authors: B
authors: Wang
authors: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, PR China.
authors: X
authors: X
authors: Zhang
authors: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, PR China.
authors: J
authors: J
authors: Xiang
authors: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
authors: J
authors: J
authors: Shi
authors: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
authors: M
authors: M
authors: Tian
authors: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, PR China.
authors: A
authors: A
authors: Zhang
authors: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
authors: H
authors: H
authors: Chang
authors: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
authors: K
authors: K
authors: Qu
authors: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
authors: C
authors: C
authors: Liu
authors: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
authors: L
authors: L
authors: Yu
authors: Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, PR China. Electronic address: luyi169@126.com.
authors: Y
authors: Y
authors: Lv
mesh_terms: D000328:Adult; D001926:Brain Death; D002681:China; D003643:Death; D005260:Female; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome