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2011, Number 4

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Ann Hepatol 2011; 10 (4)

Should donation after cardiac death liver grafts be used for retransplantation?

Perry DK, Willingham DL, Sibulesky L, Bulatao IG, Nguyen JH, Taner CB
Full text How to cite this article

Language: English
References: 7
Page: 482-485
PDF size: 40.71 Kb.


Key words:

Donation after cardiac death, Liver retransplantation.

ABSTRACT

Introduction. Donation after cardiac death (DCD) donors provide an important source of livers that has been used to expand the donor pool. As a consequence of increased numbers of OLT, allograft failure due to early and late complications and disease recurrence are more commonly encountered. The only life saving treatment for patients with liver allograft failure is liver re-transplantation (LR). The use of DCD liver grafts for LR is controversial. Material and methods. Between February 1998 and June 2008, 10 patients underwent LR with DCD allografts. Five (50%) patients had no post operative complications. The 30 day, 1 year, and 3 year patient survival are 80, 60, and 60%, respectively. When DCD grafts are used for sick patients with high MELD scores for LR, the patient and graft survivals are prohibitively low. Conclusion. We do not recommend utilization of DCD liver grafts for LR if a candidate recipient has moderate to high MELD score.


REFERENCES

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  2. Doyle HR, Morelli F, McMichael J, et al. Hepatic retransplantation: an analysis of risk factors associated with outcome. Transplantation 1996; 61: 1499-505.

  3. Institute of Medicine DoHCS. Non-heart-beating organ transplantation: In: Medical and Ethical Issues in Procurement. Washington, DC: National Academy Press; 1997.

  4. Foley DP, Fernandez LA, Leverson G, Chin LT, Krieger N, et al. Donation after cardiac death: the University of Wisconsin experience with liver transplantation. Ann Surgery 2005; 242(5): 724-31.

  5. Pine JK, Aldouri A, Young AL, Davies MH, Attia M, et al. Liver transplantation following donation after cardiac death: an analysis using matched pairs. Liver Transplant 2009; 15: 1072-82.

  6. Biggins SW, Beldecos A, Rabkin JM, et al. Retransplantation for hepatic allograft failure: prognostic modeling and ethical considerations. Liver Transplant 2002; 8: 313-22.

  7. Watt K, Lyden ER, McCashland TM. Poor survival after liver retransplantation: is hepatitis C to blame? Liver Transplant 2003; 9: 1019-24.




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Ann Hepatol. 2011;10