Long-term outcomes of donation after cardiac death liver allografts from a single center

Clin Transplant. 2009 Mar-Apr;23(2):168-73. doi: 10.1111/j.1399-0012.2009.00968.x. Epub 2009 Feb 11.

Abstract

Organ shortage continues to be a major challenge in transplantation. Recent experience with controlled non-heart-beating or donation after cardiac death (DCD) are encouraging. However, long-term outcomes of DCD liver allografts are limited. In this study, we present outcomes of 19 DCD liver allografts with follow-up >4.5 years. During 1998-2001, 19 (4.1%) liver transplants (LT) with DCD allografts were performed at our center. Conventional heart-beating donors included 234 standard criteria donors (SCD) and 214 extended criteria donors (ECD). We found that DCD allografts had equivalent rates of primary non-function and biliary complications as compared with SCD and ECD. The overall one-, two-, and five-yr DCD graft and patient survival was 73.7%, 68.4%, and 63.2%, and 89.5%, 89.5%, and 89.5%, respectively. DCD graft survival was similar to graft survival of SCD and ECD in non hepatitis C virus (HCV) recipients (p > 0.370). In contrast, DCD graft survival was significantly reduced in HCV recipients (p = 0.007). In conclusion, DCD liver allografts are durable and have acceptable long-term outcomes. Further research is required to assess the impact of HCV on DCD allograft survival.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Death*
  • Female
  • Follow-Up Studies
  • Graft Rejection / etiology*
  • Graft Survival*
  • Hepacivirus / pathogenicity
  • Hepatitis C / virology
  • Humans
  • Liver Transplantation / statistics & numerical data*
  • Male
  • Middle Aged
  • Organ Preservation
  • Postoperative Complications
  • Prognosis
  • Risk Factors
  • Survival Rate
  • Time Factors
  • Tissue Donors
  • Tissue and Organ Procurement*
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult