Applicability and Results of Maastricht Type 2 Donation After Cardiac Death Liver Transplantation

作者:Fondevila C*; Hessheimer A J; Flores E; Ruiz A; Mestres N; Calatayud D; Paredes D; Rodriguez C; Fuster J; Navasa M; Rimola A; Taura P; Garcia Valdecasas J C
来源:American Journal of Transplantation, 2012, 12(1): 162-170.
DOI:10.1111/j.1600-6143.2011.03834.x

摘要

Maastricht type 2 donation after cardiac death (DCD) donors suffer sudden and unexpected cardiac arrest, typically outside the hospital; they have significant potential to expand the donor pool. Herein, we analyze the results of transplanted livers and all potential donors treated under our type 2 DCD protocol. Cardiac arrest was witnessed; potential donors arrived at the hospital after attempts at resuscitation had failed. Death was declared based on the absence of cardiorespiratory activity during a 5-min no-touch period. Femoral vessels were cannulated to establish normothermic extracorporeal membrane oxygenation, which was maintained until organ recovery. From April 2002 to December 2010, there were 400 potential donors; 34 liver transplants were performed (9%). Among recipients, median age, model for end-stage liver disease and cold and reperfusion warm ischemic times were 55 years (4960), 19 (1421) and 380 (325430) and 30 min (2635), respectively. Overall, 236 (59%) and 130 (32%) livers were turned down due to absolute and relative contraindications to donate, respectively. One-year recipient and graft survivals were 82% and 70%, respectively (median follow-up 24 months). The applicability of type 2 DCD liver transplant was %26lt;10%; however, with better preservation technology and expanded transplant criteria, we may be able to improve this figure significantly.

  • 出版日期2012-1