Controlled donation after circulatory death up to 80 years for liver transplantation: Pushing the limit again

Am J Transplant. 2020 Jan;20(1):204-212. doi: 10.1111/ajt.15537. Epub 2019 Aug 13.

Abstract

Our main objective was to compare liver transplant (LT) results between donation after circulatory death (DCD) and donation after brainstem death (DBD) in our hospital and to analyze, within the DCD group, the influence of age on the results obtained with DCD donors aged >70 years and up to 80 years. All DCD-LTs performed were analyzed prospectively. The results of the DCD group were compared with those of a control group who received a DBD-LT immediately after each DCD-LT. Later, the results obtained within the DCD group were analyzed according to the age of the donors, considering 2 subgroups with a cut-off point at 70 years. Survival results for LT with DCD and super rapid recovery were not inferior to those obtained in a similar group of patients transplanted with DBD livers. However, the cost of DCD was a higher rate of biliary complications, including ischemic cholangiopathy. Donor age was not a negative factor.

Keywords: clinical research/practice; donors and donation; donors and donation: deceased; donors and donation: donation after brain death (DBD); donors and donation: donation after circulatory death (DCD); donors and donation: extended criteria; health services and outcomes research; liver transplantation/hepatology; organ procurement and allocation; organ transplantation in general.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiovascular System
  • Death*
  • Female
  • Follow-Up Studies
  • Graft Rejection / diagnosis*
  • Graft Rejection / etiology
  • Graft Survival*
  • Humans
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Tissue Donors / supply & distribution*
  • Tissue and Organ Procurement / statistics & numerical data*
  • Young Adult