Document Detail


Liver transplantation using non-heart-beating donors: Belgian experience.
MedLine Citation:
PMID:  17580167     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mortality on liver transplantation (OLT) waiting lists has increased dramatically. Until recently, non-heart-beating donors (NHBD) were not considered suitable for OLT, because of a higher risk of primary graft nonfunction (PNF) and biliary strictures. However, recent experimental/clinical evidence has indicated that NHBD-OLT is feasible when the period of warm ischemia is short. PURPOSE: To characterize the results of NHBD-OLT in Belgium, a survey was sent to all Belgian OLT centers. RESULTS: Between January 2003 and November 2005, 16 livers originating from NHBD were procured and transplanted. The mean donor age was 48.8 years, including 9 males and 7 females with mean time of stop-therapy to cardiac arrest being 18 minutes and from cardiac arrest to liver cold perfusion, 10.5 minutes. Mean recipient age was 52.2 years including 12 males and 4 females. Mean cold ischemia time was 7 hours 15 minutes. No PNF requiring re-OLT was observed. Mean post-OLT peak transaminase was 2209 IU/L, which was higher among imported versus locally procured grafts. Biliary complications occurred in 6 patients requiring re-OLT (n = 2), endoscopic treatment (n = 2), surgical treatment (n = 1), or left untreated (n = 1). These tended to be more frequent after prolonged warm ischemia. Graft and patient survivals were 62.5% and 81.3%, respectively, with a follow-up of 3 to 36 months. CONCLUSION: This survey showed acceptable graft/patient survivals after NHBD-LT. The NHBD-liver grafts suffered a high rate of ischemic injury and biliary complications and therefore should be used carefully, namely with no additional donor risk factors, lower risk recipients, and short cold/warm ischemia.
Authors:
D Monbaliu; F Van Gelder; R Troisi; B de Hemptinne; J Lerut; R Reding; J de Ville de Goyet; O Detry; A De Roover; P Honore; V Donckier; M Gelin; D Ysebaert; R Aerts; W Coosemans; J Pirenne
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Transplantation proceedings     Volume:  39     ISSN:  0041-1345     ISO Abbreviation:  Transplant. Proc.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-20     Completed Date:  2007-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1481-4     Citation Subset:  IM    
Affiliation:
Abdominal Transplant Surgery Department, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium. Diethard.Monbaliu@uz.kuleuven.ac.be
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MeSH Terms
Descriptor/Qualifier:
Adult
Belgium
Female
Heart Arrest*
Humans
Liver Function Tests
Liver Transplantation / mortality,  physiology*
Male
Middle Aged
Retrospective Studies
Survival Analysis
Tissue Donors / statistics & numerical data
Waiting Lists

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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