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Annals of Transplantation is one of the fast-developing journals open to all scientists and fields of transplant medicine and related research. The journal is published quarterly and provides extensive coverage of the most important advances in transplantation.
Using an electronic on-line submission and peer review tracking system, Annals of Transplantation is committed to rapid review and publication. The average time... read more

Published: 2018-11-20

Impact of Donor Pre-Procurement Cardiac Arrest (PPCA) on Clinical Outcomes in Liver Transplantation

Richard S. Mangus, Joel R. Schroering, Jonathan A. Fridell, Chandrashekhar A. Kubal

(Transplant Division, Department of Surgery, Indiana University, School of Medicine, Indianapolis, USA)

Ann Transplant 2018; 23:808-814

DOI: 10.12659/AOT.910387

BACKGROUND: Transplantation of liver grafts from deceased donors who experienced cardiac arrest prior to liver procurement is now common. This single-center study analyzed the impact of pre-donation arrest time on clinical outcomes in liver transplantation.
MATERIAL AND METHODS: Records of all orthotopic liver transplants performed at a single center over a 15-year period were reviewed. Donor records were reviewed and total arrest time was calculated as cumulative minutes. Post-transplant liver graft function was assessed using laboratory values. Graft survival was assessed with Cox regression analysis.
RESULTS: Records for 1830 deceased donor transplants were reviewed, and 521 donors experienced pre-procurement cardiac arrest (28%). Median arrest time was 21 min (mean 25 min, range 1–120 min). After transplant, the peak alanine aminotransferase and bilirubin levels for liver grafts from donors with arrest were lower compared to those for donors without arrest (p<0.001). Early allograft dysfunction occurred in 25% (arrest) and 28% (no arrest) of patients (p=0.22). There were no differences in risk of early graft loss (3% vs. 3%, p=0.84), length of hospital stay (10 vs. 10 days, p=0.76), and 1-year graft survival (89% vs. 89%, p=0.94). Cox regression analysis comparing 4 groups (no arrest, <20 min, 20–40 min, and >40 min arrest) demonstrated no statistically significant difference in survival at 10 years. Subgroup analysis of 93 donation after cardiac death grafts showed no significant difference for these same outcomes.
CONCLUSIONS: These results support the use of select deceased liver donors who experience pre-donation cardiac arrest. Pre-donation arrest may be associated with less early allograft dysfunction, but had no impact on long-term clinical outcomes. The results for donation after cardiac death donors were similar.

Keywords: Donor Selection, Liver Transplantation, Outcome Assessment (Health Care)

Published: 2018-11-16

Results of Adult Living Donor Liver Transplantation with Sixth-Decade Donors: A Propensity Score Matching...

Seok-Hwan Kim, Gil-Chun Park, Shin Hwang, Chul-Soo Ahn, Ki-Hum Kim, Deok-Bog Moon, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Hwi-Dong Cho, Jae-Hyun Kwon, Yong-Kyu Jung, Su-Min Ha, Sang-Hyun Kang, Sung-Gyu Lee

Ann Transplant 2018; 23:802-807

DOI: 10.12659/AOT.911550

Published: 2018-11-13

Recurrence of Hepatitis B Infection in Liver Transplant Patients Receiving Long-Term Hepatitis B Immunogl...

Susanne Beckebaum, Kerstin Herzer, Artur Bauhofer, William Gelson, Paolo De Simone, Robert de Man, Cornelius Engelmann, Beat Müllhaupt, Julien Vionnet, Mauro Salizzoni, Riccardo Volpes, Giorgio Ercolani, Luciano De Carlis, Paolo Angeli, Patrizia Burra, Jean-François Dufour, Massimo Rossi, Umberto Cillo, Ulf Neumann, Lutz Fischer, Gabriele Niemann, Luca Toti, Guiseppe Tisone

Ann Transplant 2018; 23:789-801

DOI: 10.12659/AOT.910176