%0 Journal Article
%A Nutu, Anisa
%A García Conde, María
%A Jiménez Romero, Luis Carlos
%A Manrique Municio, Alejandro
%A Calvo Pulido, Jorge
%A Caso Maestro, Óscar
%A Marcacuzco Quinto, Alberto Alejandro
%A García-Sesma Pérez-Fuentes, Álvaro
%A Abradelo De Usera, Manuel
%A San Juan Garrido, Rafael
%A Justo Alonso, Iago
%T Liver Transplantation Using Uncontrolled Donors After Circulatory Death: A 10-year Single-center Experience.
%D 2019
%@ 0041-1337
%U https://hdl.handle.net/20.500.14352/102428
%X 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.
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