Livers from Donation after Circulatory Death Donors Can Be Safely Used for Retransplantation

O. van Leeuwen,¹ M. van Reeven,² J. Erdmann,³ H. Metselaar,⁴ A. van den Berg,⁵ B. van Hoek,⁶ W. Polak,² R. Porte.¹

¹Department of Surgery, University Medical Center Groningen, Groningen, Netherlands
²Department of Surgery, Erasmus Medical Center, Rotterdam, Netherlands
³Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
⁴Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, Netherlands
⁵Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, Netherlands
⁶Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Netherlands.

Meeting: 2018 American Transplant Congress

Abstract number: 242

Keywords: Donors, Graft survival, Liver transplantation, non-heart-beating, Retransplantation

Session Information

Session Name: Concurrent Session: Liver Retransplantation and Other Complications

Session Type: Concurrent Session

Date: Monday, June 4, 2018

Session Time: 2:30pm-4:00pm

Presentation Time: 3:06pm-3:18pm

Location: Room 6A

Introduction: After donation after circulatory death (DCD) liver transplantation (LT), non-anastomotic biliary strictures (NAS) and early allograft dysfunction (EAD) are more frequently observed than after donation after brain death (DBD) LT. The outcomes after retransplantation (reLT) with a DCD liver are not known. Therefore, we aimed to assess the results of patients undergoing retransplantation using a DCD liver graft.

Methods: In this multicenter retrospective study, all DCD reLTs in the Netherlands between 2003 and 2017 were included. For each DCD reLT, two DBD reLTs were selected as a matched control group. Matching was performed based on number of successive reLT, BAR-score, early (<3months) or late(≥3months) reLT and year of reLT, respectively. Baseline characteristics of both donor and recipient and outcomes parameters were collected and analyzed. EAD was defined according to the Olthoff criteria, NAS as bile duct strictures within two years after LT at any location in the biliary tree other than the anastomosis. Continuous data are shown as median (IQR).

Results: Nineteen DCD reLTs were performed during the study period. For the matched control group, 38 DBD reLTs were selected. Comparison of baseline characteristics showed no difference between DBD and DCD group, only median donor age was higher in DBD donors, compared to DCD donors (54 [39-59] vs. 38 [20-45] years, p<0.001). No significant difference was observed between DBD and DCD reLTs in post-transplant peak serum ALT values (1185 [628-2493] vs. 1238 [528-2522] u/L, p=0,729), prevalence of NAS (10,5% vs. 26,3%, p=0,143) and EAD (35,1% vs. 47,4%, p=0,375). One year graft survival after reLT was similar for DBD and DCD livers (73,7% vs. 78,9%, p=0,754).

Conclusion: Retransplantation of the liver using a DCD liver graft does not result in inferior results compared to DBD livers. DCD livers should not routinely be declined for patients requiring reLT.

CITATION INFORMATION: van Leeuwen O., van Reeven M., Erdmann J., Metselaar H., van den Berg A., van Hoek B., Polak W., Porte R. Livers from Donation after Circulatory Death Donors Can Be Safely Used for Retransplantation Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Leeuwen Ovan, Reeven Mvan, Erdmann J, Metselaar H, Berg Avanden, Hoek Bvan, Polak W, Porte R. Livers from Donation after Circulatory Death Donors Can Be Safely Used for Retransplantation [abstract]. https://atcmeetingabstracts.com/abstract/livers-from-donation-after-circulatory-death-donors-can-be-safely-used-for-retransplantation/. Accessed November 21, 2024.

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