Safety and outcomes in 100 consecutive donation after circulatory death liver transplants using a protocol that includes thrombolytic therapy

Bohorquez, H., Seal, J.B., Cohen, A.J., Kressel, A., Bugeaud, E., Bruce, D.S., Carmody, I.C., Reichman, T.W., Battula, N., Alsaggaf, M., Therapondos, G., Bzowej, N., Tyson, G., Joshi, S., Nicolau-Raducu, R., Girgrah, N. and Loss, G.E. (2017) Safety and outcomes in 100 consecutive donation after circulatory death liver transplants using a protocol that includes thrombolytic therapy. American Journal of Transplantation, 17 8: 2155-2164. doi:10.1111/ajt.14261


Author Bohorquez, H.
Seal, J.B.
Cohen, A.J.
Kressel, A.
Bugeaud, E.
Bruce, D.S.
Carmody, I.C.
Reichman, T.W.
Battula, N.
Alsaggaf, M.
Therapondos, G.
Bzowej, N.
Tyson, G.
Joshi, S.
Nicolau-Raducu, R.
Girgrah, N.
Loss, G.E.
Title Safety and outcomes in 100 consecutive donation after circulatory death liver transplants using a protocol that includes thrombolytic therapy
Journal name American Journal of Transplantation   Check publisher's open access policy
ISSN 1600-6143
1600-6135
Publication date 2017-08-01
Sub-type Article (original research)
DOI 10.1111/ajt.14261
Open Access Status Not yet assessed
Volume 17
Issue 8
Start page 2155
End page 2164
Total pages 10
Place of publication Hoboken, NJ, United States
Publisher Wiley-Blackwell Publishing
Language eng
Subject 2723 Immunology and Allergy
2747 Transplantation
2736 Pharmacology (medical)
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.
Keyword Clinical research/practice
Donation after circulatory death (DCD)
Donors and donation
Liver allograft function/dysfunction
Liver transplantation/hepatology
Organ procurement and allocation
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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