Liver Transplantation From Donation After Cardiac Death: A Single Center Experience

Fujita, Shiro; Mizuno, Shugo; Fujikawa, Takahisa; Reed, Alan; Kim, Robin D.; Howard, Richard J.; Hemming, Alan W.

doi:10.1097/01.tp.0000267424.88023.7b

Cited by 82 publications

(81 citation statements)

References 14 publications

(11 reference statements)

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“…6,[12][13][14][16][17][18]25,[28][29][30] Foley and coworkers 13 reported that rates of overall biliary complications (DCD, 47%; DBD, 26%; P < .01) and IC (DCD, 34%; DBD, 1%; P < .01) were significantly higher in the DCD group. Research conducted by Chan and associates 28 indicated no incidence of PNF from DCD allografts.…”

Section: Complications Of Livers From Donation After Cardiac Death Domentioning

confidence: 99%

“…33 For patients with severe complications after DCD liver transplant, their situation still was better than dying after refusing a DCD offer or continuing to wait for a DBD liver, because patient choices frequently are not between standard livers and marginal livers (including DCD) but rather, between marginal livers and no livers. 6 The benefit of earlier access to liver transplant provided by a DCD graft could outweigh the risks of prolonged waiting for a standard graft. 74 In Relevant to this investigation, Snyder and colleagues provided a new and informative perspective on the overall societal cost effectiveness of expanding the donor pool to include DCD kidney transplant.…”

Section: Donation After Cardiac Death Costs and Resource Utilizationmentioning

confidence: 99%

“…To assess the outcomes of patients receiving DCD liver allografts, we analyzed the available previously published literature, including several single-center studies (Table 1) 6,[12][13][14][15][16][17][18][19] and large studies (Table 2) 7,[20][21][22][23][24][25] of national databases, to compare the outcomes of recipients who received DCD versus DBD donor livers and to better understand the risk factors for graft survival, loss, and failure.…”

Section: Current Practice and Outcome Of Donation After Cardiac Deathmentioning

confidence: 99%

“…6,7 Donation after brain death (DBD) is the predominant source of organs for transplant, but brain death accounts for only a small percentage of all-cause mortality, 8 whereas cardiovascular death is a leading cause of mortality. 9 Therefore, DCD represents an attractive strategy to remedy organ shortages and decrease transplant waiting list mortality.…”

Section: Introductionmentioning

confidence: 99%

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Untitled

2015

Exp Clin Transplant

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There are increasing numbers of patients on liver transplant waiting lists, and there is a continuing organ shortage crisis. Therefore, more centers and organ procurement organizations are developing protocols for donation after cardiac death. However, the effect of donation after cardiac death allografts on overall patient survival remains controversial, with some centers reporting equivalent patient posttransplant survival but many others indicating increased rates of complications, retransplant, utilization of resources, and death. Several potential risk factors that predict graft loss and recipient complications have been identified. To improve patient outcomes and reduce dropouts, experimental strategies that target both donors and recipients at various phases of the transplant process have focused on attenuating ischemia-reperfusion injury and have achieved encouraging results. In the present article, our goal is to provide an overview of the current status of, and recent advances in, liver transplant from donation after cardiac death, to better understand the risks and potential benefits of donation after cardiac death liver transplant.

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Section: Complications Of Livers From Donation After Cardiac Death Domentioning

confidence: 99%

Section: Donation After Cardiac Death Costs and Resource Utilizationmentioning

confidence: 99%

Section: Current Practice and Outcome Of Donation After Cardiac Deathmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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2015

Exp Clin Transplant

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“…A transplant center has reported 45% (36 out of 80 patients) are candidates for liver retransplant because of biliary complications. 16 Although symptoms can be relieved, even reoperation can be avoided in some patients by improving access to organs and minimally invasive methods; [17][18][19][20][21][22][23] 30% to 50% of the diffuse duct stenosis or intrahepatic bile duct stenosis patients require a retransplant or they die of complications. 24,25 The mortality in this group of BCS patients was 13.6%, and the retransplant mortality rate was 44.0%, which demonstrates its seriousness.…”

Section: Clinical Manifestations Of Different Pathotypes Of the Biliamentioning

confidence: 99%

Pathotyping and Clinical Manifestations of Biliary Cast Syndrome in Patients After an Orthotopic Liver Transplant

Zhu¹,

Shen²,

Chen³

et al. 2013

Exp Clin Transplant

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Objectives: To summarize the pathotyping and clinical manifestations of biliary cast syndrome in patients after an orthotopic liver transplant. Materials and Methods:The clinical manifestations, auxiliary examination, therapeutic regimen, and clinical efficacy of 103 biliary cast syndrome patients who underwent an orthotopic liver transplant were retrospectively analyzed. Patients were divided into 6 groups from type 1 to type 6, according to the injury level of the biliary duct epithelium. Results: Many biliary cast syndrome patients showed symptoms including jaundice, dark urine, argillaceous stool, itchy skin, and fever. Serum levels of alanine aminotransferase, γ-glutamyl transpeptidase, alkaline phosphatase, and total bilirubin were increased. In addition, total white cell counts in peripheral blood also were increased. T-tube cholangiography showed filling defects of various amounts. Optical fiber choledochoscope examination revealed that the biliary tract was filled with solid substances, and necrosis of the biliary tract epithelium was observed in some biliary cast syndrome patients. From type 1 to type 6 biliary cast syndrome patients, the probability of clinical symptoms and biliary tract stricture gradually increased, the time needed for supporting gradually prolonged after removal of the biliary cast, and T-tube cholangiography showed that the filling defects gradually expanded. Conclusions:Clinical manifestations and cholangiography presentations mainly depend on pathotyping.

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Liver Transplantation Using Organ Donation After Cardiac Death

Yersiz²,

et al. 2011

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The mean follow-up was 2 years. Independent risk factors for graft failure after OLT were identified using Cox model and assigned risk score points. Points were summed and assigned to predictive index categories: 0 or 1 for low risk, 2 to 4 for intermediate risk, and 5 to 9 for high risk. Results: Six multivariate factors predictive for graft failure after OLT using DCD grafts included the following: for recipients, (1) diagnosis of hepatitis C virus with malignancy, non-hepatitis C virus with malignancy, or hepatitis C virus only, (2) previous OLT, and (3) body mass

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Liver Transplantation From Donation After Cardiac Death: A Single Center Experience

Cited by 82 publications

References 14 publications

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Untitled

Pathotyping and Clinical Manifestations of Biliary Cast Syndrome in Patients After an Orthotopic Liver Transplant

Liver Transplantation Using Organ Donation After Cardiac Death

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