French survey of the first three-years of liver transplantation activity from uncontrolled donors deceased after cardiac death

B Champigneulle; F Fieux; G Cheisson; F Dondero; E Savier; B Riou; O Langeron; A Nicolas-Robin

doi:10.1016/j.accpm.2014.05.001

French survey of the first three-years of liver transplantation activity from uncontrolled donors deceased after cardiac death

Anaesth Crit Care Pain Med. 2015 Feb;34(1):35-9. doi: 10.1016/j.accpm.2014.05.001. Epub 2015 Mar 5.

Authors

B Champigneulle¹, F Fieux², G Cheisson³, F Dondero⁴, E Savier⁵, B Riou⁶, O Langeron⁷, A Nicolas-Robin⁸

Affiliations

¹ Department of Anesthesiology and Critical Care, groupe hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.
² Department of Anesthesiology and Critical Care & Organ Transplant Coordination Team, hôpital Saint-Louis, AP-HP, Paris, France.
³ Department of Anesthesiology and Critical Care & Organ Transplant Coordination Team, hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France.
⁴ Hepatobiliary Surgery and Liver Transplantation Department, hôpital Beaujon, AP-HP, Clichy, France.
⁵ Hepatobiliary Surgery and Liver Transplantation Department, groupe hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.
⁶ Department of Emergency Medicine and Surgery, groupe hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; UMRS Inserm 956, université médecine Pierre-et-Marie-Curie-Paris 6, 4, place Jussieu, 75005 Paris, France.
⁷ Department of Anesthesiology and Critical Care, groupe hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; UMRS Inserm 956, université médecine Pierre-et-Marie-Curie-Paris 6, 4, place Jussieu, 75005 Paris, France.
⁸ Department of Anesthesiology and Critical Care, groupe hospitalier Pitié-Salpêtrière, AP-HP, Paris, France; UMRS Inserm 956, université médecine Pierre-et-Marie-Curie-Paris 6, 4, place Jussieu, 75005 Paris, France. Electronic address: armelle.nicolas-robin@psl.aphp.fr.

PMID: 25829313
DOI: 10.1016/j.accpm.2014.05.001

Abstract

Objective: To assess the first three years of French activity related to liver transplantation from uncontrolled donation after cardiac death (uDCD).

Study design: Prospective and observational study in the three active centres authorized by the French Biomedicine Agency.

Patients and methods: All patients deceased between 2010 and 2012 after an uncontrolled cardiac arrest admitted to one of three centres (Pitié-Salpêtrière, Saint-Louis or Bicêtre hospitals, AP-HP, Paris, France) and potentially eligible for liver recovery were included. Abdominal normothermic oxygenated recirculation (ANOR) was used for graft preservation.

Results: One hundred twenty-six potential uDCD donors were identified as eligible for liver recovery after hospital admission. The main causes of organ recovery failure were technical failure related to ANOR (29 patients, 23%), refusal of consent (39 patients, 31% of potential uDCD donors and 40% of asked relatives) and abnormal hepatic transaminases up to 200 UI.L(-1) during ANOR (24 patients, 19%). Finally, 11 livers were transplanted. Process efficiency was 9% [95% CI: 4-15%]. One-year recipient survival was 82%, [95% CI: 48-98%] and one-year graft survival was 64% [95% CI: 31-89%].

Conclusion: Liver transplantation from uDCD donors is achievable in France, despite low process efficiency.

Keywords: Donation after cardiac death; Extracorporeal membranous oxygenation; Liver transplant; Organ.

Publication types

Multicenter Study
Observational Study

MeSH terms

Adult
Endpoint Determination
Female
France
Graft Survival
Health Care Surveys*
Heart Arrest
Humans
Liver Circulation / physiology
Liver Function Tests
Liver Transplantation / standards*
Male
Middle Aged
Prospective Studies
Tissue Donors / statistics & numerical data*
Tissue and Organ Harvesting / standards*