Donation After Cardiac Death in Liver Transplantation: An Additional Source of Organs With Similar Results to Donation After Brain Death

Martínez, María Pitarch; Pérez, B. Sánchez; Díaz, F.; Aguilar, José Luis Fernández; Daga, J.A. Pérez; Casado, María Custodia Montiel; Narváez, José Manuel Aranda; Muñóz, Miguel Ángel Suárez; Santoyo, Julio Santoyo

doi:10.1016/j.transproceed.2018.02.208

Cited by 22 publications

(22 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other European countries, such as Spain and Austria, which have adopted the concept of presumed consent, achieved donation rates as high as 46.9 pmp in Spain and 23.5 pmp in Austria in 2017 [48,49]. Donation after cardiocirculatory-determined death has been shown to achieve successful results in transplantation of organs such as kidneys, livers and lungs [50][51][52][53]. In recent years, DCD programs have also been established in heart transplantation.…”

Section: Current Aspects Of Heart Transplantationmentioning

confidence: 99%

Fiftieth anniversary of the first heart transplantation in Switzerland in the context of the worldwide history of heart transplantation

Wilhelm¹,

Ruschitzka²,

Flammer³

et al. 2020

Swiss Med Wkly

View full text Add to dashboard Cite

Section: Current Aspects Of Heart Transplantationmentioning

confidence: 99%

Fiftieth anniversary of the first heart transplantation in Switzerland in the context of the worldwide history of heart transplantation

Wilhelm¹,

Ruschitzka²,

Flammer³

et al. 2020

Swiss Med Wkly

View full text Add to dashboard Cite

“…Over the last decade, donation after circulatory death (DCD) has been an increasingly utilized pathway for deceased donor organ donation as a source of grafts for liver transplantation 1–3 . The experience in multiple transplant units suggests there are increased rates of post‐transplant biliary complications in DCD recipients compared to donation from brain death (DBD) recipients 4–9 requiring a range of further interventions including re‐transplantation 2 . Therefore, liver grafts from DCD donors are being utilized both cautiously and selectively 7,9–13 .…”

Section: Introductionmentioning

confidence: 99%

“…The experience in multiple transplant units suggests there are increased rates of post‐transplant biliary complications in DCD recipients compared to donation from brain death (DBD) recipients 4–9 requiring a range of further interventions including re‐transplantation 2 . Therefore, liver grafts from DCD donors are being utilized both cautiously and selectively 7,9–13 . The Australian National Liver Transplantation Unit (ANLTU) commenced utilizing DCD liver grafts in 2007 and our early experience demonstrated good patient and graft survivals 14 .…”

Section: Introductionmentioning

confidence: 99%

“…These include older donors, prolonged cold ischaemic time (CIT) and prolonged agonal warm ischaemic times (WIT) 10,15 . These risk factors from international transplant centres may be influenced by local factors including donor and recipient selection, and management practices 9–12,16 . In order to understand the potential donor and recipient risk factors associated with biliary complications within an Australian DCD liver transplant population, a focused retrospective analysis of all recipients transplanted with a DCD liver graft at the ANLTU was undertaken.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Biliary complications in donation after circulatory death liver transplantation: the Australian National Liver Transplantation Unit's experience

Crawford

Verran

2020

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background Biliary complications are the most common complications of donation after circulatory death (DCD) liver transplantation and the international experience with DCD transplants suggests increased rates of biliary complications compared to donation after brain death transplants. Therefore, it is important to understand factors that are associated with the development of biliary complications within the Australian DCD context in order to inform future practice. The aim of this study is to determine the incidence of biliary complications after DCD liver transplantation at the Australian National Liver Transplantation Unit and identify factors associated with this outcome. Methods A retrospective analysis of all adult DCD liver transplants at the Australian National Liver Transplantation Unit from 2007 to 2015 was undertaken. The primary outcome measure was the incidence of biliary complications and was censored on 31 December 2016. Recipients were then stratified into groups based on the development of biliary complications and risk factor analysis was performed. Results Biliary complications occurred in 35% of DCD transplants, including seven anastomotic strictures and 10 non‐anastomotic strictures. Higher donor risk index scores (P = 0.03), post‐transplant portal vein complications (P = 0.042) and peak gamma‐glutamyl transferase levels within 7 days post‐transplant (P = 0.047) were associated with biliary complications. Conclusion Findings from this study demonstrate that biliary complications remain common in DCD liver recipients. Recipients who developed a biliary complication tended to have higher donor risk index, elevated peak gamma‐glutamyl transferase levels within 7 days post‐transplant or a portal vein complication. The presence of any of these factors should prompt close monitoring for post‐transplant biliary complications.

show abstract

“…( 4,5 ) As best practices have been described and the frequency of transplanted DCD livers has increased over time, the optimal utilization of livers from DCD donors and identification of appropriate recipients has resulted in improved outcomes, approaching those seen in DBD donors. ( 6‐9 ) As results from multicenter studies have become available, the liver transplantation (LT) community has improved in identifying optimal cutoffs for critical risk factors that impact graft failure or patient death in DCD LT. ( 10 ) These factors include donor and recipient age, body mass index (BMI), Model for End‐Stage Liver Disease (MELD) score, cold ischemia time (CIT), and donor warm ischemia time (WIT). ( 8,11 ) The number of DCD LTs has increased from 4.8% (n = 274) in 2008 to 6.9% (n = 531) in 2018.…”

mentioning

confidence: 99%

Microsteatosis in Livers From Donation After Circulatory Death Donors Is Associated With Inferior Outcomes Following Liver Transplantation

et al. 2020

View full text Add to dashboard Cite

The acceptable threshold remains unknown for the percentage of macrosteatosis (MaS) and microsteatosis (MiS) to yield optimal outcomes after donation after circulatory death (DCD) liver transplantation (LT). The purpose of this analysis was to determine the impact of donor liver MaS and MiS on DCD LT outcomes. Using the Organ Procurement and Transplantation Network database, we analyzed pretransplant biopsy results from adult, solitary, DCD livers transplanted between January 1, 2006, and December 31, 2017. Kaplan‐Meier analysis was used to assess graft and patient survival based on MaS and MiS severity. MiS was divided into the groups MiS ≤10% and >10%. MaS was divided into the groups MaS ≤15% and >15%. Of 7757 recovered DCD livers, 11.4% (n = 885) were biopsied and transplanted. Patients who received DCD livers with MaS >15% had significantly worse patient survival (P < 0.04), and those with MiS >10% demonstrated inferior graft and patient survival (P < 0.02). In multivariate analyses including known risk factors, both MaS >15% and MiS >10% were associated with increased risk of graft failure and patient mortality (P < 0.03). Recipient and donor age >60 years were also associated with increased risk of graft failure and patient death. This analysis demonstrates that MaS >15% and MiS >10% are additional risk factors for graft loss and patient mortality in DCD LT.

show abstract

Donation After Cardiac Death in Liver Transplantation: An Additional Source of Organs With Similar Results to Donation After Brain Death

Cited by 22 publications

References 18 publications

Fiftieth anniversary of the first heart transplantation in Switzerland in the context of the worldwide history of heart transplantation

Fiftieth anniversary of the first heart transplantation in Switzerland in the context of the worldwide history of heart transplantation

Biliary complications in donation after circulatory death liver transplantation: the Australian National Liver Transplantation Unit's experience

Microsteatosis in Livers From Donation After Circulatory Death Donors Is Associated With Inferior Outcomes Following Liver Transplantation

Contact Info

Product

Resources

About