Selected liver grafts from donation after circulatory death can be safely used for retransplantation - a multicenter retrospective study
| Autor: | Wojciech G. Polak, Bart van Hoek, Robert J. Porte, Ian P.J. Alwayn, Aad P. van den Berg, Otto B. van Leeuwen, Marjolein van Reeven, Danny van der Helm, Sarwa Darwish Murad |
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| Přispěvatelé: | Groningen Institute for Organ Transplantation (GIOT), Surgery, Gastroenterology & Hepatology |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Reoperation
medicine.medical_specialty Brain Death Tissue and Organ Procurement medicine.medical_treatment liver retransplantation Ischemia DONORS donation after circulatory death patient outcomes 030230 surgery Liver transplantation 03 medical and health sciences 0302 clinical medicine Clinical Research PERFUSION RELT Medicine Humans Netherlands Retrospective Studies RISK liver transplantation business.industry TRANSPLANTATION Incidence (epidemiology) Graft Survival Retrospective cohort study medicine.disease Circulatory death Tissue Donors deceased donors Surgery Death Liver Donation Propensity score matching NONANASTOMOTIC BILIARY STRICTURES 030211 gastroenterology & hepatology Original Article graft outcomes business |
| Zdroj: | Transplant International Transplant International, 33(6), 667-674. Wiley Transplant International, 33(6), 667-674. WILEY Transplant International, 33(6), 667-674. Wiley-Blackwell Publishing Ltd |
| ISSN: | 0934-0874 |
| Popis: | textabstractDue to the growing number of liver transplantations (LTs), there is an increasing number of patients requiring retransplantation (reLT). Data on the use of grafts from extended criteria donors (ECD), especially donation after circulatory death (DCD), for reLT are lacking. We aimed to assess the outcome of patients undergoing reLT using a DCD graft in the Netherlands between 2001 and July 2018. Propensity score matching was used to match each DCD-reLT with three DBD-reLT cases. Primary outcomes were patient and graft survival. Secondary outcome was the incidence of biliary complications, especially nonanastomotic strictures (NAS). 21 DCD-reLT were compared with 63 matched DBD-reLTs. Donors in the DCD-reLT group had a significantly lower BMI (22.4 vs. 24.7 kg/m2, P-value = 0.02). Comparison of recipient demographics and ischemia times yielded no significant differences. Patient and graft survival rates were comparable between the two groups. However, the occurrence of nonanastomotic strictures after DCD-reLT was significantly higher (38.1% vs. 12.7%, P-value = 0.02). ReLT with DCD grafts does not result in inferior patient and graft survival compared with DBD grafts in selected patients. Therefore, DCD liver grafts should not routinely be declined for patients awaiting reLT. |
| Databáze: | OpenAIRE |
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