Single-Center Experience With Liver Transplantation From Controlled Non-Heartbeating Donors

Muiesan, Paolo; Girlanda, Raffaele; Jassem, Wayel; Melendez, Hector Vilca; O’Grady, John; Bowles, Matthew; Rela, Mohamed; Heaton, Nigel

doi:10.1097/01.sla.0000186177.26112.d2

Cited by 153 publications

(119 citation statements)

References 18 publications

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“…Many of these groups showed poorer graft and/or patient survival when compared with recipients of DBD donors. 3,4,9,12,13,[25][26][27][28] A comprehensive approach allows our center to control for factors like donor age, WIT, CIT, asystole-to-flush time, and preservation solution that previously have been shown to contribute to IHBS. 3,4,10,26,[29][30][31] Each DCD donor offered to our center is critically assessed regarding donor age, location, serologies, and probability of timely death, by assessing respiratory effort and the need for vasopressors.…”

Section: Discussionmentioning

confidence: 99%

Liver Transplant Using Donors After Cardiac Death: A Single-Center Approach Providing Outcomes Comparable to Donation After Brain Death

Vanatta

Dean

Hathaway³

et al. 2013

Exp Clin Transplant

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Objectives: 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. 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.

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Section: Discussionmentioning

confidence: 99%

Liver Transplant Using Donors After Cardiac Death: A Single-Center Approach Providing Outcomes Comparable to Donation After Brain Death

Vanatta

Dean

Hathaway³

et al. 2013

Exp Clin Transplant

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“…Interestingly, some groups have compared the outcomes with those with CNHBDs and BDDs and reported similar graft and recipient survival as well as a low postoperative complication rate. [8][9][10][11][12][13] It is accepted by most teams that CNHBD liver transplantation could be used as a strategy to increase the donor pool. However, many issues regarding UNHBDs remain unclear, and this keeps this graft source underused.…”

Section: Discussionmentioning

confidence: 99%

Liver transplantation using uncontrolled non-heart-beating donors under normothermic extracorporeal membrane oxygenation

et al. 2009

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Because of the organ shortage, non-heart-beating donors have been proposed as a possible source of grafts for orthotopic liver transplantation (OLT). Despite the widespread use of controlled non-heart-beating donors, there are only a few published studies reporting the outcomes with uncontrolled non-heart-beating donors (UNHBDs). A prospective case-control study on adult patients undergoing OLT was designed. We used normothermic extracorporeal membrane oxygenation (NECMO) in all UNHBDs. Matching 2:1 ratio comparison was performed between a study group (UNHBDs) and a brain death donor (BDD) control group. Between January 2006 and March 2008, a total of 60 patients were included: 20 in the UNHBD group and 40 in the control group. The incidence of ischemic cholangiopathy was 5% (n ϭ 1) for the UNHBD group and 0% for the BDD group (P ϭ 0.15). The rate of primary nonfunction was 10% (n ϭ 2) in UNHBD recipients and 2.5% (n ϭ 1) in BDD recipients (P ϭ 0.21), with graft loss in all of them. Three patients were retransplanted in the UNHBD group (15%), 2 of them because of primary nonfunction and 1 because of ischemic cholangiopathy; no patient was retransplanted in the control group (P ϭ 0.012). After a mean follow-up of 330.4 Ϯ 224.9 days, 1-year cumulative patient survival was 85.5% for the UNHBD group and 87.5% for the BDD group (P ϭ 0.768). One-year cumulative graft survival was 80% in the UNHBD group and 87.5% in the BDD group (P ϭ 0.774). In conclusion, UNHBDs under NECMO are a potential source of organs for OLT with encouraging outcomes potentially comparable to those obtained with BDDs.

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“…Even after careful pre-retrieval donor selection, up to 45% of retrieved livers from DCD donors are discarded due to doubts about viability [12]. In the UK 2011/12 only 689 of 782 (88%) of all deceased donor livers retrieved were actually transplanted, falling to 132 of 178 (74%) for livers from DCD donors (NHSBT data).…”

Section: Viability Assessmentmentioning

confidence: 99%

A multicentre randomised controlled trial to compare the efficacy of ex-vivo normothermic machine perfusion with static cold storage in human liver transplantation

Nasralla¹,

Akhtar²,

Bradley³

et al. 2018

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Single-Center Experience With Liver Transplantation From Controlled Non-Heartbeating Donors

Abstract: Early results suggest that controlled NHBDs are a significant new source of grafts, but careful donor selection and short cold ischemia are mandatory.

Cited by 153 publications

References 18 publications

Liver Transplant Using Donors After Cardiac Death: A Single-Center Approach Providing Outcomes Comparable to Donation After Brain Death

Liver Transplant Using Donors After Cardiac Death: A Single-Center Approach Providing Outcomes Comparable to Donation After Brain Death

Liver transplantation using uncontrolled non-heart-beating donors under normothermic extracorporeal membrane oxygenation

A multicentre randomised controlled trial to compare the efficacy of ex-vivo normothermic machine perfusion with static cold storage in human liver transplantation

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