Long-term outcomes of donation after cardiac death liver allografts from a single center

• Published in: Clinical transplantation Vol. 23; no. 2; pp. 168 - 173
• Main Authors: Nguyen, Justin H., Bonatti, Hugo, Dickson, Rolland C., Hewitt, Winston R., Grewal, Hani P., Willingham, Darrin L., Harnois, Denise M., Schmitt, Timothy M., Machicao, Victor I., Ghabril, Marwan S., Keaveny, Andrew P., Aranda-Michel, Jaime, Satyanarayana, Raj, Rosser, Barry G., Hinder, Ronald A., Steers, Jeffery L., Hughes, Christopher B.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.2009; Wiley
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Child; Child, Preschool; Death; donation after cardiac death; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Rejection - etiology; Graft Survival; Hepacivirus - pathogenicity; Hepatitis C - virology; Hepatitis C virus; Humans; liver transplantation; Liver Transplantation - statistics & numerical data; Liver, biliary tract, pancreas, portal circulation, spleen; long-term outcome; Male; Medical sciences; Middle Aged; nonheart-beating donor; Organ Preservation; Postoperative Complications; Prognosis; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival Rate; Time Factors; Tissue and Organ Procurement; Tissue Donors; Tissue, organ and graft immunology; Transplantation, Homologous; Treatment Outcome; Young Adult; Heart; Suboptimal donor; Human; beating donor; Center; Prognosis; Digestive system; Liver; Mortality; donation after cardiac death; nonheart; Homotransplantation; Long term; Medicine; Treatment; Surgery; Donation; long-term outcome; Evolution; Graft; Death; Circulatory system; Liver transplantation
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/j.1399-0012.2009.00968.x

:  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.