Introduction: Herein, we present the short-term results of a controlled DCD liver transplantation program with pre-mortem cannulation and normothermic extracorporeal membrane oxygenation (NECMO) preservation.

Material and methods: At our hospital, we have implemented a DCD liver transplantation program with donor cannulation prior to withdrawal of treatment and normothermic extracorporeal membrane oxygenation (NECMO) preservation. Every donor was connected to NECMO and transferred to the operating room where it was perfused with cold preservation solution (Celsior[copy]) and stored for implantation. Recipients were selected according to our allocation criteria.

Results:Between January and October 2015, ten potential donors were enrolled and connected to the NECMO system. One graft was discarded due to a significant increase in transaminases level during preservation. Thus, nine controlled (Maastricht category III) DCD liver transplantations preserved with NECMO were performed. The median warm ischemia time was 13 min (7 -18) and NECMO duration 135 min (90 -161). Transaminases and lactate levels remained stable or slightly increased during NECMO. By reperfusion, two recipients (22%) developed postreperfusion syndrome and fibrinolysis. During the immediate postoperatory period, the median aminotransferase (ALT) peak was 1410 U/L (573 -3588), four patients (56%) could be extubated within the first 10 hours, three patients presented early graft dysfunction(43%) and renal replacement therapy was only necessary in one patient (11%). To date, with a median follow up of six months all patients are alive, with good renal and liver function without retransplantation and neither clinical nor radiological suspicion of cholangiopathy.

Conclusion: We believe that even though the short follow-up and the small number of patients limit the study, our initial experience suggests that short-term outcomes of DCD liver transplant with premortem cannulation and preserved with NECMO could be comparable to the DBD and offer a new choice to using DCD donors.

CITATION INFORMATION: Ruiz P, Gastaca M, Valdivieso A, Ventoso A, Palomares I, Prieto M, Bustamante J, Salvador P, Ortiz de Urbina J. Pre-Mortem Cannulation and NECMO Preservation for DCD Liver Transplantation. Am J Transplant. 2016;16 (suppl 3).

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