Non-heart beating donation; NHBD; results; organ transplantation
Abstract :
[en] BACKGROUND: Results of donation after circulatory death (DCD) liver transplantation are impaired by graft loss, resulting mainly from non-anastomotic biliary stricture. Donor age is a risk factor in deceased donor liver transplantation, and particularly in DCD liver transplantation. At the authors' institute, age is not an absolute exclusion criterion for discarding DCD liver grafts, DCD donors receive comfort therapy before withdrawal, and cold ischaemia is minimized. METHODS: All consecutive DCD liver transplantations performed from 2003 to 2012 were studied retrospectively. Three age groups were compared in terms of donor and recipient demographics, procurement and transplantation conditions, peak laboratory values during the first post-transplant 72 h, and results at 1 and 3 years. RESULTS: A total of 70 DCD liver transplants were performed, including 32 liver grafts from donors aged 55 years or less, 20 aged 56-69 years, and 18 aged 70 years or more. The overall graft survival rate at 1 month, 1 and 3 years was 99, 91 and 72 per cent respectively, with no graft lost secondary to non-anastomotic stricture. No difference other than age was noted between the three groups for donor or recipient characteristics, or procurement conditions. No primary non-function occurred, but one patient needed retransplantation for artery thrombosis. Biliary complications were similar in the three groups. Graft and patient survival rates were no different at 1 and 3 years between the three groups (P = 0.605). CONCLUSION: Results for DCD liver transplantation from younger and older donors were similar. Donor age above 50 years should not be a contraindication to DCD liver transplantation if other donor risk factors (such as warm and cold ischaemia time) are minimized.
Disciplines :
Surgery Gastroenterology & hepatology
Author, co-author :
DETRY, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
DE ROOVER, Arnaud ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
MEURISSE, Nicolas ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
HANS, Marie-France ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Delwaide, Jean ; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
LAUWICK, Séverine ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
KABA, Abdourahmane ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
JORIS, Jean ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
Meurisse, Michel ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgicale abdominale
Honoré, Pierre ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgicale abdominale
Language :
English
Title :
Donor age as a risk factor in donation after circulatory death liver transplantation in a controlled withdrawal protocol programme.
Publication date :
July 2014
Journal title :
British Journal of Surgery
ISSN :
0007-1323
eISSN :
1365-2168
Publisher :
John Wiley & Sons, Hoboken, United States - New Jersey
Volume :
10
Issue :
7
Pages :
784-792
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
(c) 2014 BJS Society Ltd. Published by John Wiley & Sons, Ltd.
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