Liver transplantation from donation after cardiac death

doi:10.3877/cma.j.issn.1674-0793.2014.04.009

Abstract

Abstract:

Objective

To summarize the organ procurement process and clinical experiences in liver transplantation from donation after cardiac death.

Methods

The clinical data of 12 recipients undergoing liver transplantation from donation after cardiac death and pretreatment, procurement of 12 donors from Oct 2008 to Dec 2012 in Zhongshan City People's Hospital were retrospectively analyzed.

Results

The twelve donors were in the status of brain death awaiting cardiac death and had donated livers successfully. Of them, 3 donors were treated with extracoporeal membrane oxygenation (ECMO). The warm ischemia time of donation was 0-30 (16.5±7.0) min. Liver transplantation was successfully performed on all recipients. There was no mortality during operation. 2 recipients suffered from biliary complication, 1 from tumor recurrence, and 2 recipients were dead during follow-up.

Conclusions

DCD might obtain satisfactory transplant outcomes and acceptable postoperative complications. Rapid procurement and ECMO can improve utilization rate and decrease warm and cold ischemia time of the liver.

Key words: Donation after cardiac death, Liver transplantation, Extracoporeal membrane oxygenation

Qiang Sun, Yuanlong Yu, Zemin Hu, Hong Chen, Zhigang Guo. Liver transplantation from donation after cardiac death[J]. Chinese Archives of General Surgery(Electronic Edition), 2014, 08(04): 290-293.

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Figures/Tables 2

References 15

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指标	数值范围	±s
体重指数（BMI，kg/m²）	18.55~23.47	21.35±1.35
尿量（ml）	0~200	85±62
WBC（×10^９/ml）	2.5~24.3	9.5±5.2
Hb（g/L）	48~123	91.3±28.4
AST（U/L）	11~620	155.1±128.6
ALT（U/L）	14~494	166.0±110.5
Tbil（μmol/L）	5.7~48.7	22.0±15.6
ALB（g/L）	15.6~41.8	32.9±8.1
肌酐（μmol/L）	58.2~194	115.6±49.3
热缺血时间（min）	0~30	16.5±7.0
冷缺血时间（h）	4~10	6.8±1.9
供肝质量（g）	925~1428	1146±165.3

指标	数值范围	±s
体重指数（BMI，kg/m²）	18.55~23.47	21.35±1.35
尿量（ml）	0~200	85±62
WBC（×10^９/ml）	2.5~24.3	9.5±5.2
Hb（g/L）	48~123	91.3±28.4
AST（U/L）	11~620	155.1±128.6
ALT（U/L）	14~494	166.0±110.5
Tbil（μmol/L）	5.7~48.7	22.0±15.6
ALB（g/L）	15.6~41.8	32.9±8.1
肌酐（μmol/L）	58.2~194	115.6±49.3
热缺血时间（min）	0~30	16.5±7.0
冷缺血时间（h）	4~10	6.8±1.9
供肝质量（g）	925~1428	1146±165.3

术后时间（d）	AST（U/L）	ALT（U/L）	GGT（U/L）	TBIL（μmol/L）
1	654.8±471.4	269.5±142.5	87.3±56.7	135.6±128.0
2	383.7±479.5	235.2±197.0	112.1±48.8	106.8±109.7
3	172.4±126.8	163.7±117.9	319.2±350.3	100.9±109.7
5	61.1±22.7	112.1±64.0	535.7±433.0	60.7±78.3
7	46.8±23.9	71.7±35.9	607.2±563.3	39.4±40.4
14	36.8±10.1	72.2±38.2	451.3±255.2	31.7±27.6
30	37.8±16.4	52.7±51.9	185.6±151.1	22.5±11.0

术后时间（d）	AST（U/L）	ALT（U/L）	GGT（U/L）	TBIL（μmol/L）
1	654.8±471.4	269.5±142.5	87.3±56.7	135.6±128.0
2	383.7±479.5	235.2±197.0	112.1±48.8	106.8±109.7
3	172.4±126.8	163.7±117.9	319.2±350.3	100.9±109.7
5	61.1±22.7	112.1±64.0	535.7±433.0	60.7±78.3
7	46.8±23.9	71.7±35.9	607.2±563.3	39.4±40.4
14	36.8±10.1	72.2±38.2	451.3±255.2	31.7±27.6
30	37.8±16.4	52.7±51.9	185.6±151.1	22.5±11.0

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