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Long-term outcomes of donation after cardiac death liver allografts from a single center

Authors

  • Justin H. Nguyen,

    1. Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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  • Hugo Bonatti,

    1. Department of Surgery, University of Virginia, Charlottesville, VA, USA
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    • *

      Dr. Hugo Bonatti is a visiting surgical fellow who contributed equally to the preparation of this article. Dr. Bonatti is sponsored by the Detiger fellowship.

  • Rolland C. Dickson,

    1. Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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  • Winston R. Hewitt,

    1. Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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  • Hani P. Grewal,

    1. Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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  • Darrin L. Willingham,

    1. Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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  • Denise M. Harnois,

    1. Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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  • Timothy M. Schmitt,

    1. Department of Surgery, University of Virginia, Charlottesville, VA, USA
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  • Victor I. Machicao,

    1. Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, USA
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  • Marwan S. Ghabril,

    1. Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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  • Andrew P. Keaveny,

    1. Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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  • Jaime Aranda-Michel,

    1. Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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  • Raj Satyanarayana,

    1. Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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  • Barry G. Rosser,

    1. Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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  • Ronald A. Hinder,

    1. Department of Surgery, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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  • Jeffery L. Steers,

    1. Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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  • Christopher B. Hughes

    1. Divisions of Transplant Surgery and Transplant Hepatology, Department of Transplantation, Mayo Clinic College of Medicine, Jacksonville, FL, USA
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Justin H. Nguyen, MD, Division of Transplant Surgery, Mayo Clinic College of Medicine, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
Tel.: 904 956 3261; fax: 904 956 3359;
e-mail: nguyen.justin@mayo.edu

Abstract

Abstract:  Organ shortage continues to be a major challenge in transplantation. Recent experience with controlled non-heart-beating or donation after cardiac death (DCD) are encouraging. However, long-term outcomes of DCD liver allografts are limited. In this study, we present outcomes of 19 DCD liver allografts with follow-up >4.5 years. During 1998–2001, 19 (4.1%) liver transplants (LT) with DCD allografts were performed at our center. Conventional heart-beating donors included 234 standard criteria donors (SCD) and 214 extended criteria donors (ECD). We found that DCD allografts had equivalent rates of primary non-function and biliary complications as compared with SCD and ECD. The overall one-, two-, and five-yr DCD graft and patient survival was 73.7%, 68.4%, and 63.2%, and 89.5%, 89.5%, and 89.5%, respectively. DCD graft survival was similar to graft survival of SCD and ECD in non hepatitis C virus (HCV) recipients (p > 0.370). In contrast, DCD graft survival was significantly reduced in HCV recipients (p = 0.007). In conclusion, DCD liver allografts are durable and have acceptable long-term outcomes. Further research is required to assess the impact of HCV on DCD allograft survival.

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