Article (Scientific journals)
Donation after cardio-circulatory death liver transplantation.
Le Dinh; DE ROOVER, Arnaud; KABA, Abdourahmane et al.
2012In World Journal of Gastroenterology, 18 (33), p. 4491-506
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Abstract :
[en] The renewed interest in donation after cardio-circulatory death (DCD) started in the 1990s following the limited success of the transplant community to expand the donation after brain-death (DBD) organ supply and following the request of potential DCD families. Since then, DCD organ procurement and transplantation activities have rapidly expanded, particularly for non-vital organs, like kidneys. In liver transplantation (LT), DCD donors are a valuable organ source that helps to decrease the mortality rate on the waiting lists and to increase the availability of organs for transplantation despite a higher risk of early graft dysfunction, more frequent vascular and ischemia-type biliary lesions, higher rates of re-listing and re-transplantation and lower graft survival, which are obviously due to the inevitable warm ischemia occurring during the declaration of death and organ retrieval process. Experimental strategies intervening in both donors and recipients at different phases of the transplantation process have focused on the attenuation of ischemia-reperfusion injury and already gained encouraging results, and some of them have found their way from pre-clinical success into clinical reality. The future of DCD-LT is promising. Concerted efforts should concentrate on the identification of suitable donors (probably Maastricht category III DCD donors), better donor and recipient matching (high risk donors to low risk recipients), use of advanced organ preservation techniques (oxygenated hypothermic machine perfusion, normothermic machine perfusion, venous systemic oxygen persufflation), and pharmacological modulation (probably a multi-factorial biologic modulation strategy) so that DCD liver allografts could be safely utilized and attain equivalent results as DBD-LT.
Disciplines :
Surgery
Author, co-author :
Le Dinh
DE ROOVER, Arnaud ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
KABA, Abdourahmane ;  Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
LAUWICK, Séverine ;  Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
JORIS, Jean ;  Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
DELWAIDE, Jean ;  Centre Hospitalier Universitaire de Liège - CHU > Gastro-Entérologie-Hépatologie
Honoré, Pierre ;  Université de Liège - ULiège > Département des sciences cliniques > Chirurgicale abdominale
Meurisse, Michel ;  Université de Liège - ULiège > Département des sciences cliniques > Chirurgicale abdominale
DETRY, Olivier  ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Language :
English
Title :
Donation after cardio-circulatory death liver transplantation.
Publication date :
September 2012
Journal title :
World Journal of Gastroenterology
ISSN :
1007-9327
eISSN :
2219-2840
Publisher :
WJG Press, China
Volume :
18
Issue :
33
Pages :
4491-506
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 14 October 2012

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