Liver transplantation using uncontrolled non-heart-beating donors under normothermic extracorporeal membrane oxygenation
Open Access
- 28 August 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Liver Transplantation
- Vol. 15 (9), 1110-1118
- https://doi.org/10.1002/lt.21867
Abstract
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 = 1) for the UNHBD group and 0% for the BDD group (P = 0.15). The rate of primary nonfunction was 10% (n = 2) in UNHBD recipients and 2.5% (n = 1) in BDD recipients (P = 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 = 0.012). After a mean follow‐up of 330.4 ± 224.9 days, 1‐year cumulative patient survival was 85.5% for the UNHBD group and 87.5% for the BDD group (P = 0.768). One‐year cumulative graft survival was 80% in the UNHBD group and 87.5% in the BDD group (P = 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. Liver Transpl 15:1110–1118, 2009. © 2009 AASLD.Keywords
This publication has 26 references indexed in Scilit:
- Liver Transplant Using Donors After Unexpected Cardiac Death: Novel Preservation Protocol and Acceptance CriteriaAmerican Journal of Transplantation, 2007
- Long-Term Results for Liver Transplantation From Non–Heart-Beating Donors Mantained With Chest and Abdominal Compression-DecompressionTransplantation Proceedings, 2005
- Donation After Cardiac DeathAnnals of Surgery, 2005
- Liver transplantation from Maastricht category 2 non-heart-beating donorsTransplantation, 2003
- Liver transplantation from controlled non–heart-beating donors: an increased incidence of biliary complicationsTransplantation, 2003
- Use of older controlled non-heart-beating donors for liver transplantationTransplantation, 2003
- Liver transplantation from controlled non-heart–beating donorsSurgery, 2000
- CONTROLLED NON-HEART-BEATING DONOR LIVER TRANSPLANTATIONTransplantation, 2000
- NON-HEART-BEATING DONORS FROM THE STREETSTransplantation, 2000
- Experience With Liver And Kidney Allografts From Non-Heart-Beating DonorsTransplantation, 1995