Risk assessment of outcomes using grafts from donors after cardiac death

Xinguo Chen; Qing Zhang; Lihua Yin; Wei LI; Fengdong WU; Weilong Zou; Yi Wang; Xiongwei Zhu; Hong Chen; Yang Yue; Yonglin Deng; Zhongyang Shen

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Risk assessment of outcomes using grafts from donors after cardiac death

VernacularTitle:“中国二类”和“中国三类”供者相关因素对肝移植预后的影响
Author: Xinguo CHEN ; Qing ZHANG ; Lihua YIN ; Wei LI ; Fengdong WU ; Weilong ZOU ; Yi WANG ; Xiongwei ZHU ; Hong CHEN ; Yang YUE ; Yonglin DENG ; Zhongyang SHEN
Keywords: Donor after cardiac death; Liver transplantation; Recipients; Prognosis
From: Chinese Journal of Organ Transplantation 2017;38(5):287-291
CountryChina
Language:Chinese
Abstract: Objective To assess the effects of the risk factors of grafts from donors after cardiac death (DCD) on the prognosis of liver transplantation (LT).Methods In this retrospectively study,215 cases of LT using DCD donor grafts were performed at our institution from September 2013 to January 2017.Due to the loss to follow-up in 4 cases,211 cases were enrolled in the study.The following DCD donor data were collected:gender,age,primary disease,ABO blood type,body mass index (BMI),medical history (fatty liver,hypertension),ICU hospitalization time,mechanical ventilation time,warm ischemia time,cold ischemia time,and indexes of routine laboratory test before donation.Statistical analyses using the Kaplan-Meier method,log-rank test,multivariate step-wise Cox regression were performed.Results Of the 211 donors,univariate analysis showed that the overall 6-month,1-,and 3-year survival rate after DCD LT was 88％,84％,and 82％,respectively.Univariate analysis showed that donor serum sodium level ＜136 mmol/L (P =0.018) and cold ischemia time ＞9 h (P =0.013) were all significant risk factors affecting overall survival after DCD LT.Additionally,donor BMI ＞30 kg/m2 (P =0.011) and donor age ＞60 years (P =0.025) were significantly associated with postoperative complications.Multivariate analysis showed that donor serum sodium level (P=0.025) was an independent risk factor of survival after DCD LT.Conclusion To select suitable DCD liver allografts and control risk factors of donor can help to improve outcomes of recipients.