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A SINGLE CENTER EXPERIENCE WITH 157 CONTROLED DCD-LIVER TRANSPLANTATIONS
Schielke, Astrid Anita; Paolucci, Maité; MEURISSE, Nicolas et al.
2019In Transplant International, 32 (S2), p. 029 p165
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Abstract :
[en] Introduction: Donation after circulatory death (DCD) have been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of graft loss and retransplantation. The authors retrospectively reviewed a single centre experience with controlled DCD-LT in a 15-year period. Patients and Methods: 157 DCD-LT were consecutively performed between 2003 and 2017. All donation and procurement procedures were performed as controlled DCD in the operating theatre. Data are presented as median (ranges). Median donor age was 57 years (16–83). Median DRI was 2.242 (1.322–3.554). Allocation was centre-based. Median recipient MELD score at LT was 15 (6–40). Mean follow-up was 37 months. No patient was lost to follow-up. Results: Median total DCD warm ischemia was 19 min (7–39). Median total ischemia was 313 min (181–586). Patient survivals were 89.8%, 75.5% and 73.1% at 1,3 and 5 years, respectively. Graft survivals were 89%, 73.8% and 69.8% at 1,3 and 5 years, respectively. Biliary complications included mainly anastomotic strictures, that were managed either by endoscopy or hepatico- jejunostomy. Two patients were retransplanted due to intrahepatic ischemic lesions. Conclusion: In this series, DCD LT provides results similar to classical LT. Short cold ischemia and recipient selection with low MELD score may be the keys to good results in DCD LT, in terms of graft survival and avoidance of ischemic cholangiopathy.
Disciplines :
Anesthesia & intensive care
Gastroenterology & hepatology
Surgery
Author, co-author :
Schielke, Astrid Anita ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
Paolucci, Maité ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Département de chirurgie
MEURISSE, Nicolas ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
Vandermeulen, Morgan ;  Université de Liège - ULiège > Département des sciences cliniques > Chirurgicale abdominale
LAMPROYE, Anne ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de gastroentérologie, hépatologie, onco. digestive
DELWAIDE, Jean ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de gastroentérologie, hépatologie, onco. digestive
JORIS, Jean ;  Centre Hospitalier Universitaire de Liège - CHU > Département d'Anesthésie et réanimation > Service d'anesthésie - réanimation
KABA, Abdourahmane ;  Centre Hospitalier Universitaire de Liège - CHU > Département d'Anesthésie et réanimation > Service d'anesthésie - réanimation
HONORE, Pierre ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
DETRY, Olivier  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
Language :
English
Title :
A SINGLE CENTER EXPERIENCE WITH 157 CONTROLED DCD-LIVER TRANSPLANTATIONS
Publication date :
October 2019
Event name :
19th Congress
Event organizer :
European Society for Organ Transplantation (ESOT)
Event place :
Copenhagen, Denmark
Event date :
du 15 au 18 septembre 2019
Audience :
International
Journal title :
Transplant International
ISSN :
0934-0874
eISSN :
1432-2277
Publisher :
Blackwell, Oxford, United Kingdom
Volume :
32
Issue :
S2
Pages :
BOS029 p165
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 19 November 2019

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