Abstract
Background. The use of organs from non-heart-beating donors (NHBDs) has been proposed as one
way to increase the donor pool. However, few centers have transplanted livers from
NHBDs. We report here the results of 19 liver transplants from controlled NHBDs. Methods. From January 1993 through August 1999, 364 liver transplantations were performed
from heart-beating donors (HBDs) and 19 liver transplantations were performed from
NHBDs. Donor and recipient characteristics, posttransplant complications, and patient
and allograft survival were compared. Results. No differences in hepatic artery, portal vein, or biliary complications were noted
between the groups. However, the rate of primary nonfunction was higher in recipients
of livers from NHBDs (10.5% vs 1.3%; P =.04). No difference in patient survival was seen between recipients of NHBDs or
HBDs (72.6% vs 84.8%; P =.36); however, allograft survival was lower in recipients who received livers from
NHBDs (53.8% vs 80.9%; P =.007). Conclusions. Liver transplantation from controlled NHBDs results in similar patient survival and
post-transplant complications. However, primary nonfunction was higher and allograft
survival was less in recipients of livers from NHBDs. The results of liver transplantation
from controlled NHBDs are encouraging and should continue to be cautiously pursued
as one way to help alleviate the current shortage of donor livers.(Surgery 2000;128:579-88.)
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References
- (Richmond, Va)United Network for Organ Sharing. February 25, 2000
- Right lobe living donor liver transplantation: a review.Liver Transpl. 2000; 6: 3-20
- Living related liver transplantation in children.Am J Surg. 1994; 168: 41-48
- Split liver transplantation.Ann Surg. 1999; 229: 313-321
Becker YT. Use of marginal donors in kidney transplantation. Graft. In press.
- Non-heart-beating donors: one response to the organ shortage.Transplant Rev. 1995; 9: 168-176
- Renal transplantation from non-heart-beating donors: opportunities and challenges.Transplant Rev. 2000; 14: 1-17
- Successful extrarenal transplantation from non-heart-beating donors.Transplantation. 1995; 59: 977-982
- Non-heart-beating organ transplantation: medical and ethical issues in procurement.National Academy Press, Washington (DC)1997
D'Alessandro AM, Odorico JS, Knechtle SJ, Becker YT, Hoffmann RM, Kalayoglu M, et al. Simultaneous pancreas-kidney transplantation from controlled non-heart-beating donors. Cell Transplant. In press.
- Retransplantation of the liver: a single center experience [abstract].in: American Society of Transplant Surgeons 24th Annual Scientific Meeting, Chicago, IllMay 13-15 1998
- Changing donor and recipient demographics affects long-term renal allograft outcome [abstract].in: American Society of Transplantation 18th Annual Meeting, Chicago, IllMay 15-19 1999
- Excellent long-term graft survival with kidneys from the uncontrolled non-heart-beating donor.Transplant Proc. 2000; 32: 186-187
- Estimation and characterization of the potential renal organ donor pool in Pennsylvania: report of the Pennsylvania Statewide Donor Study.Transplantation. 1991; 51: 142-149
- Non-heart-beating organ transplantation: practice and protocols.National Academy Press, Washington (DC)2000
- Procurement of liver allografts from non-heart-beating donors.Transplant Proc. 1990; 22: 275-278
- Experience with human liver grafts obtained after donor cardiac standstill.Transplant Proc. 1987; 19: 3862-3863
- Experience with liver and kidney allografts from non-heart-beating donors.Transplantation. 1995; 59: 197-203
- Liver transplantation with organs from non-heart-beating donors.Transplant Proc. 1997; 29: 3478-3479
- Risk factors for primary dysfunction after liver transplantation: a multivariate analysis.Transplantation. 1993; 55: 807-813
- Vascular occlusions for liver resections: operative management and tolerance to hepatic ischemia—142 cases.Ann Surg. 1989; 209: 211-218
- L-arginine during liver procurement from non-heart-beating donor pigs: histological evaluation.Transplant Proc. 1999; 31: 1069
- Organ preserving effect of lidocaine administration in the model of orthotopic liver transplantation from non-heart-beating donors.Transplant Proc. 1996; 28: 1928-1929
- Endothelin antagonist treatment for successful liver transplantation from non-heart-beating donors.Transplantation. 1999; 67: 328-332
- Machine perfusion of the liver: maintenance of mitochondrial function after 48-hour preservation.Transplant Proc. 1997; 29: 3452-3454
Article info
Footnotes
*Reprint requests: Anthony M. D'Alessandro, MD, Department of Surgery, University of Wisconsin Hospital and Clinics, 600 Highland Ave, Madison, WI 53792-7375.
**Surgery 2000;128:579-88
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
