Liver transplantation with donation after cardiac death donors: A comprehensive update
In: Journal of Surgical Research, Jg. 178 (2012-11-01), Heft 1, S. 502-511
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Abstract: Background: Use of donation after cardiac death (DCD) donors has been proposed as an effective way to expand the availability of hepatic allografts used in orthotopic liver transplantation (OLT); yet, there remains no consensus in the medical literature as to how to choose optimal recipients and donors based on available information. Methods: We queried the United Network of Organ Sharing/Organ Procurement and Transplantation Network database for hepatic DCD allografts used in OLT. As of March 31, 2011, 85,148 patients received hepatic allografts from donation-after-brain-death (DBD) donors, and 2351 patients received hepatic allografts from DCD donors. We performed survival analysis using log-rank and Kaplan-Meier tests. We performed univariate and multivariate analyses using the Cox proportional hazards model. All statistics were performed with SPSS 15.0. Results: Patients receiving hepatic DCD allografts had significantly worse survival compared with patients receiving hepatic DBD allografts. Pediatric patients who received a hepatic DCD allograft had similar survival to those who received a hepatic DBD allograft. The optimal recipient-related characteristics were age <50 y, International Normalized Ratio <2.0, albumin >3.5 gm/dL, and cold ischemia time <8 h; optimal donor-related characteristics included age <50 y and donor warm ischemia time <20 min. Conclusions: By identifying certain characteristics, the transplant clinician’s decision-making process can be assisted so that similar survival outcomes after OLT can be achieved with the use of hepatic DCD allografts. [Copyright &y& Elsevier]
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Liver transplantation with donation after cardiac death donors: A comprehensive update
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Autor/in / Beteiligte Person: | Harring, Theresa R. ; Nguyen, N. Thao T. ; Cotton, Ronald T. ; Guiteau, Jacfranz J. ; Salas de Armas, Ismael A. ; Liu, Hao ; Goss, John A. ; O’Mahony, Christine A. |
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Zeitschrift: | Journal of Surgical Research, Jg. 178 (2012-11-01), Heft 1, S. 502-511 |
Veröffentlichung: | 2012 |
Medientyp: | academicJournal |
ISSN: | 0022-4804 (print) |
DOI: | 10.1016/j.jss.2012.04.044 |
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