Similar liver transplantation survival with selected cardiac death donors and brain death donors (Br J Surg 2010; 97: 744-753).

摘要

Demand for transplantation has driven the use of organs from donors after cardiac death (DCD), also known as non-heart-beating donors. DCD organ retrieval inevitably prolongs warm ischaemia time compared with retrieval from heart-beating donors (donation after brain death, DBD) and results in more tissue injury and higher frequencies of delayed or suboptdmal graft function. This study from the Netherlands has applied a careful protocol for selection of suitable DCD grafts and demonstrates good results from DCD liver transplants. The study shows equivalent 1- and 3-year patient survival rates, and graft survival rates not significantly different from those of DBD transplants. In keeping with other studies, non-anastomotic biliary stricturing was more common with DCD grafts. This stricturing remains a major challenge for liver transplantation and will probably incur a longer-term burden of retransplantation.