Faculty Collaboration Database

Safety and Outcomes in 100 Consecutive Donation After Circulatory Death Liver Transplants Using a Protocol That Includes Thrombolytic Therapy. Am J Transplant 2017 Aug;17(8):2155-2164

Date

03/10/2017

Pubmed ID

28276658

DOI

10.1111/ajt.14261

Scopus ID

2-s2.0-85017433865 (requires institutional sign-in at Scopus site)   84 Citations

Abstract

Donation after circulatory death (DCD) liver transplantation (LT) reportedly yields inferior survival and increased complication rates compared with donation after brain death (DBD). We compare 100 consecutive DCD LT using a protocol that includes thrombolytic therapy (late DCD group) to an historical DCD group (early DCD group n = 38) and a cohort of DBD LT recipients (DBD group n = 435). Late DCD LT recipients had better 1- and 3-year graft survival rates than early DCD LT recipients (92% vs. 76.3%, p = 0.03 and 91.4% vs. 73.7%, p = 0.01). Late DCD graft survival rates were comparable to those of the DBD group (92% vs. 93.3%, p = 0.24 and 91.4% vs. 88.2%, p = 0.62). Re-transplantation occurred in 18.4% versus 1% for the early and late DCD groups, respectively (p = 0.001). Patient survival was similar in all three groups. Ischemic-type biliary lesions (ITBL) occurred in 5%, 3%, and 0.2% for early DCD, late DCD, and DBD groups, respectively, but unlike in the early DCD group, in the late DCD group ITBL was endoscopically managed and resolved in each case. Using a protocol that includes a thrombolytic therapy, DCD LT yielded patient and graft survival rates comparable to DBD LT.

Author List

Bohorquez H, Seal JB, Cohen AJ, Kressel A, Bugeaud E, Bruce DS, Carmody IC, Reichman TW, Battula N, Alsaggaf M, Therapondos G, Bzowej N, Tyson G, Joshi S, Nicolau-Raducu R, Girgrah N, Loss GE

Author

Narendra Battula MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Bile Duct Diseases
Death
Donor Selection
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Liver Transplantation
Male
Middle Aged
Postoperative Complications
Prognosis
Retrospective Studies
Risk Factors
Survival Rate
Thrombolytic Therapy
Tissue Donors
Tissue and Organ Procurement
Vascular Diseases
Young Adult