RT Journal Article
T1 Liver transplantation using uncontrolled donors after circulatory death: A 10-years single-center experience
A1 Jiménez Romero, Luis Carlos
A1 Manrique Municio, Alejandro
A1 Calvo Pulido, Jorge
A1 Caso Maestro, Óscar
A1 Marcacuzco Quinto, Alberto Alejandro
A1 García-Sesma Pérez-Fuentes, Álvaro
A1 Abradelo De Usera, Manuel
A1 Nutu, OA
A1 Garcia Conde, María
A1 San Juan Garrido, Rafael
A1 Justo Alonso, Iago
AB Background. One method for increasing the donor pool for orthotopic liver transplantations (OLTs) is to use uncontrolled donation after circulation death (uDCDs).Methods. From January 2006 to December 2016, we performed 75 OLTs using uDCD livers. The control group comprised a sample of 265 OLTs using livers of donations after brain death (DBDs). A comparative study was performed.Results. Of 256 potential uDCD donors cannulated, 75 (29.3%) livers were accepted for OLT. The amount of hemoderivatives transfused was significantly higher in the uDCD group. The rate of primary nonfunction was also significantly higher (P = 0.031) in uDCD recipients (8%) than DBD recipients (1.5%). The overall rate of biliary complications was significantly higher (P = 0.001) in uDCD recipients (23 cases, 30.6%) than DBD recipients (28 cases, 10.6%). In the uDCD group, 1-, 3-, and 5-year patient survival rates were 82.7%, 73%, and 71.5%, respectively; in the DBD group, they were 89%, 83.7%, and 78.8%, respectively (P = 0.180). In the uDCD group, 1-, 3-, and 5-year graft survival rates were 73.3%, 65.1%, and 63.6%, respectively; in the DBD group, they were 87.1%, 81.9%, and 76.5%, respectively (P = 0.013). Multivariate analysis showed that independent risk factors for patient and graft survival were intraoperative transfusion of >6 units of packed red blood cell concentrates and recipients who were older than 60 years.Conclusions. Although graft survival is significantly lower using uDCD livers, 5-year patient survival in recipients of DBD and uDCD livers is similar. After careful selection, the livers of uDCD can be selectively used for OLT.
PB Lippincot
YR 2019
FD 2019-04-09
LK https://hdl.handle.net/20.500.14352/100003
UL https://hdl.handle.net/20.500.14352/100003
LA eng
NO Jiménez-Romero C, Manrique A, Calvo J, Caso Ó, Marcacuzco A, García-Sesma Á, Abradelo M, Nutu A, García-Conde M, San Juan R, Justo I. Liver Transplantation Using Uncontrolled Donors After Circulatory Death: A 10-year Single-center Experience. Transplantation. 2019 Dec;103(12):2497-2505. doi: 10.1097/TP.0000000000002780. PMID: 31765364.
DS Docta Complutense
RD 9 abr 2025