Outcomes of Adult Liver Transplantation from Donation After Brain Death Followed by Circulatory Death in China
Jiabin Zhang, Hui Ren, Yanling Sun, Zhijie Li, Hongbo Wang, Zhenwen Liu, Shaotang Zhou
(Center of Hepatopancreatobiliary Surgery and Liver Transplantation, 302 Hospital, Beijing, China (mainland))
Ann Transplant 2018; 23:285-291
Organ donation from a deceased donor, which is donation after brain death followed by circulatory death, is a unique transplantation practice in China. Pathological features of grafts help guide the utilization of grafts.
MATERIAL AND METHODS: We retrospectively reviewed our experiences in 188 DBCD allografts from May 2014 to April 2017. We divided 183 transplanted allografts into 3 groups according to pretransplant histology: the good quality graft group (n=62), the preservation injury group (n=27), and the steatotic graft group (n=94). Univariate and multivariate analyses were performed to identify factors in the steatotic graft group predicting the prognoses.
RESULTS: The prevalence rates of allografts in the good quality, steatotic liver, and preservation injury groups were 33.0% (62/188), 50.0% (94/188), and 14.4%(27/188), respectively, and the discarded rate was 2.7% (5/188). The 1- and 3-year overall survival rates were 92.1% and 88.1%, respectively. There were no differences in 1- and 3-year patient survival among the 3 groups (p=0.615). Some complications occurred: acute rejection in 7 cases, lung infection in 11 recipients, biliary stricture and bile leak in 9 patients, and portal thrombosis in 1 recipient; 17 recipients died of various causes. Cox multivariate analysis revealed that longer cold storage time was associated with worse outcome in the steatotic graft group.
CONCLUSIONS: Clinical outcomes of adult liver transplantation from deceased donation in China are acceptable.
Keywords: Biopsy, Fine-Needle, Liver Transplantation, Patient Outcome Assessment, Tissue and Organ Procurement