Evolving utilization of donation after circulatory death livers in liver transplantation: The day of DCD has come.
ex vivo liver perfusion
graft survival
liver transplant
machine perfusion
retransplantation
Journal
Clinical transplantation
ISSN: 1399-0012
Titre abrégé: Clin Transplant
Pays: Denmark
ID NLM: 8710240
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
revised:
29
11
2020
received:
14
09
2020
accepted:
21
12
2020
pubmed:
29
12
2020
medline:
2
7
2021
entrez:
28
12
2020
Statut:
ppublish
Résumé
Compared to donation after brain death (DBD), livers procured for transplantation from donation after circulatory death (DCD) donors experience more ischemia-reperfusion injury and higher rates of ischemic cholangiopathy due to the period of warm ischemic time (WIT) following withdrawal of life support. As a result, utilization of DCD livers for liver transplant (LT) has generally been limited to short WITs and younger aged donor grafts, causing many recovered DCD organs to be discarded without consideration for transplant. This study assesses how DCD liver utilization and outcomes have changed over time, using OPTN data from adult, first-time, deceased donor, whole-organ LTs between January 1995 and December 2019. Results show that increased clinical experience with DCD LT has translated into increased use of livers from DCD donors, shorter ischemic times, shorter lengths of hospitalization after transplant, and lower rates of retransplantation. The data also reveal that over the past decade, the rate of increase in DCD LTs conducted in the United States has outpaced that of DBD. Together, these trends signal an opportunity for the field of liver transplantation to mitigate the organ shortage by capitalizing on DCD liver allografts that are currently not being utilized.
Identifiants
pubmed: 33368701
doi: 10.1111/ctr.14211
pmc: PMC7969458
mid: NIHMS1676544
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14211Subventions
Organisme : NIDDK NIH HHS
ID : R01 DK107875
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK096075
Pays : United States
Informations de copyright
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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