Long-term outcomes of donation after cardiac death liver allografts from a single center

Justin H. Nguyen, Hugo Bonatti, Rolland C. Dickson, Winston R. Hewitt, Hani P. Grewal, Darrin L. Willingham, Denise M. Harnois, Timothy M. Schmitt, Victor I. Machicao, Marwan Ghabril, Andrew P. Keaveny, Jaime Aranda-Michel, Raj Satyanarayana, Barry G. Rosser, Ronald A. Hinder, Jeffery L. Steers, Christopher B. Hughes

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Organ shortage continues to be a major challenge in transplantation. Recent experience with controlled non-heart-beating or donation after cardiac death (DCD) are encouraging. However, long-term outcomes of DCD liver allografts are limited. In this study, we present outcomes of 19 DCD liver allografts with follow-up >4.5 years. During 1998-2001, 19 (4.1%) liver transplants (LT) with DCD allografts were performed at our center. Conventional heart-beating donors included 234 standard criteria donors (SCD) and 214 extended criteria donors (ECD). We found that DCD allografts had equivalent rates of primary non-function and biliary complications as compared with SCD and ECD. The overall one-, two-, and five-yr DCD graft and patient survival was 73.7%, 68.4%, and 63.2%, and 89.5%, 89.5%, and 89.5%, respectively. DCD graft survival was similar to graft survival of SCD and ECD in non hepatitis C virus (HCV) recipients (p>0.370). In contrast, DCD graft survival was significantly reduced in HCV recipients (p=0.007). In conclusion, DCD liver allografts are durable and have acceptable long-term outcomes. Further research is required to assess the impact of HCV on DCD allograft survival.

Original languageEnglish (US)
Pages (from-to)168-173
Number of pages6
JournalClinical Transplantation
Volume23
Issue number2
DOIs
StatePublished - 2009
Externally publishedYes

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Allografts
Liver
Tissue Donors
Graft Survival
Hepacivirus
Transplantation
Transplants
Research

Keywords

  • Donation after cardiac death
  • Liver transplantation
  • Long-term outcome
  • Nonheartbeating donor

ASJC Scopus subject areas

  • Transplantation

Cite this

Nguyen, J. H., Bonatti, H., Dickson, R. C., Hewitt, W. R., Grewal, H. P., Willingham, D. L., ... Hughes, C. B. (2009). Long-term outcomes of donation after cardiac death liver allografts from a single center. Clinical Transplantation, 23(2), 168-173. https://doi.org/10.1111/j.1399-0012.2009.00968.x

Long-term outcomes of donation after cardiac death liver allografts from a single center. / Nguyen, Justin H.; Bonatti, Hugo; Dickson, Rolland C.; Hewitt, Winston R.; Grewal, Hani P.; Willingham, Darrin L.; Harnois, Denise M.; Schmitt, Timothy M.; Machicao, Victor I.; Ghabril, Marwan; Keaveny, Andrew P.; Aranda-Michel, Jaime; Satyanarayana, Raj; Rosser, Barry G.; Hinder, Ronald A.; Steers, Jeffery L.; Hughes, Christopher B.

In: Clinical Transplantation, Vol. 23, No. 2, 2009, p. 168-173.

Research output: Contribution to journalArticle

Nguyen, JH, Bonatti, H, Dickson, RC, Hewitt, WR, Grewal, HP, Willingham, DL, Harnois, DM, Schmitt, TM, Machicao, VI, Ghabril, M, Keaveny, AP, Aranda-Michel, J, Satyanarayana, R, Rosser, BG, Hinder, RA, Steers, JL & Hughes, CB 2009, 'Long-term outcomes of donation after cardiac death liver allografts from a single center', Clinical Transplantation, vol. 23, no. 2, pp. 168-173. https://doi.org/10.1111/j.1399-0012.2009.00968.x
Nguyen, Justin H. ; Bonatti, Hugo ; Dickson, Rolland C. ; Hewitt, Winston R. ; Grewal, Hani P. ; Willingham, Darrin L. ; Harnois, Denise M. ; Schmitt, Timothy M. ; Machicao, Victor I. ; Ghabril, Marwan ; Keaveny, Andrew P. ; Aranda-Michel, Jaime ; Satyanarayana, Raj ; Rosser, Barry G. ; Hinder, Ronald A. ; Steers, Jeffery L. ; Hughes, Christopher B. / Long-term outcomes of donation after cardiac death liver allografts from a single center. In: Clinical Transplantation. 2009 ; Vol. 23, No. 2. pp. 168-173.
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abstract = "Organ shortage continues to be a major challenge in transplantation. Recent experience with controlled non-heart-beating or donation after cardiac death (DCD) are encouraging. However, long-term outcomes of DCD liver allografts are limited. In this study, we present outcomes of 19 DCD liver allografts with follow-up >4.5 years. During 1998-2001, 19 (4.1{\%}) liver transplants (LT) with DCD allografts were performed at our center. Conventional heart-beating donors included 234 standard criteria donors (SCD) and 214 extended criteria donors (ECD). We found that DCD allografts had equivalent rates of primary non-function and biliary complications as compared with SCD and ECD. The overall one-, two-, and five-yr DCD graft and patient survival was 73.7{\%}, 68.4{\%}, and 63.2{\%}, and 89.5{\%}, 89.5{\%}, and 89.5{\%}, respectively. DCD graft survival was similar to graft survival of SCD and ECD in non hepatitis C virus (HCV) recipients (p>0.370). In contrast, DCD graft survival was significantly reduced in HCV recipients (p=0.007). In conclusion, DCD liver allografts are durable and have acceptable long-term outcomes. Further research is required to assess the impact of HCV on DCD allograft survival.",
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AU - Grewal, Hani P.

AU - Willingham, Darrin L.

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AU - Machicao, Victor I.

AU - Ghabril, Marwan

AU - Keaveny, Andrew P.

AU - Aranda-Michel, Jaime

AU - Satyanarayana, Raj

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