Organ donationLiver transplantation from maastricht category 2 non–heart-beating donors: a source to increase the donor pool?
Section snippets
Donor characteristics
Livers from Maastricht category 2 NHBDs were harvested at 2 hospitals: Hospital Juan Canalejo, La Coruña (n = 6), and Hospital Clínico San Carlos, Madrid (n = 14).
Organ preservation
Two methods of preservation were used according to where the NHBDs occurred. In Hospital Juan Canalejo, the donor remained in the emergency room, and, 5 minutes after declaration of death, CPS was initiated to preserve organ viability. CPS included the maneuvers of CPR with simultaneous application of chest (mechanical) and abdominal
Results
From December 1995 through March 2000, 276 liver transplantations were performed at Hospital Juan Canalejo. In 20 (7%) the donor was a Maastricht category 2 NHBD whose organs were preserved after death declaration either with CPS or CPB.
Discussion
In the present study, transplantation of livers from Maastricht category 2 NHBDs was associated with a patient survival similar to that observed with organs from HBDs; but a graft survival rate that was 18% lower. Four of 5 livers that failed showed PNF, whereas the other graft failed because of biliary strictures. The latter complication as well as a more severe degree of initial liver dysfunction were observed more frequently in grafts from NHBDs than those from HBDs. The higher incidence of
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The viability of transplanting organs from donors who underwent cardiopulmonary resuscitation: A systematic review
2016, ResuscitationCitation Excerpt :A total of 12,206 adult and 2552 paediatric organ transplants were identified. For the seven uncontrolled DCD studies30–36 all were observational data which was not reported as prospective or retrospective. The yield per uncontrolled DCD donor was reported in two studies as 1.534 and 1.4.37
Part 4: Advanced life support. 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations
2015, ResuscitationCitation Excerpt :For the important outcome of immediate graft survival, low-quality evidence from nonrandomized studies did not detect any worse outcome when organs were recovered from non–heart-beating donors with ongoing CPR compared with other types of donors for adult kidneys (203 organs357–360) or adult livers (64 organs355,358,361,362). For the important outcome of graft survival for 1 year, low-quality evidence from nonrandomized studies did not detect any worse outcome when organs were recovered from non–heart-beating donors with ongoing CPR compared with other types of donors for adult kidneys (199 organs357,358,360) or adult livers (60 organs355,358,361). For the important outcome of graft survival for 5 years, low-quality evidence from nonrandomized studies did not detect any worse outcome when organs were recovered from non–heart-beating donors with ongoing CPR compared with other types of donors for adult kidneys (177 organs357,360) or adult livers (34 organs355).
HOPE for human liver grafts obtained from donors after cardiac death
2014, Journal of HepatologyCitation Excerpt :Liver grafts donated after cardiac death (DCD) are associated with increased reperfusion injury, post-transplant morbidity [1–3], graft loss [2,4–6], and cost [3,7].
Non-heart-beating donors (then) and donation after cardiac death (now)
2007, Transplantation ReviewsCitation Excerpt :In a Cox multivariate analysis, only cold ischemia time was identified as a significant risk factor for NHBD graft survival [92]. Spanish surgeons reported on 20 NHBDs in which the liver donor was maintained by simultaneous chest and abdominal compression (n = 6) or by cardiopulmonary bypass (n = 14) [93]. Although the 2-year patient survival rate was 80%, graft survival was only 55%, and there was a 25% incidence of PNF.
Transplantation From Non-Heart-Beating Donors
2007, Transplantation ProceedingsCitation Excerpt :Early experience with NHBDs was associated with unsatisfactory patient and graft survival; particularly for the uncontrolled NHBD group.3 Graft loss was mainly attributed to primary nonfunction and vascular complications.4 However, the development of techniques such as mechanical chest and abdominal compression, cardiopulmonary bypass, and extra corporeal membrane oxygenation may contribute to improvement of the outcome of uncontrolled NHBDs.