Experience summary of 182 patients undergoing liver transplantation from donation after cardiac death in a single center
10.3969/j.issn.1674-7445.2017.05.009
- VernacularTitle:心脏死亡器官捐献供肝肝移植182例单中心经验总结
- Author:
Liangshuo HU
1
;
Jianhua SHI
;
Min TIAN
;
Huanchen SHA
;
Xiaogang ZHANG
;
Xuemin LIU
;
Chang LIU
;
Liang YU
;
Yi LYU
;
Bo WANG
Author Information
1. 710061,西安交通大学医学院第一附属医院肝胆外科
- Keywords:
Liver transplantation;
Donation after cardiac death;
Donation after citizen's death;
End-stage liver disease;
Cancer,liver cell;
Billiary tract complication;
Early allograft dysfunction;
Acute kidney injury;
Pulmonary infection
- From:
Organ Transplantation
2017;8(5):381-385
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical efficacy of liver transplantation from donation after cardiac death (DCD). Methods Clinical data of both the donors and recipients (n=182) undergoing liver transplantation from DCD were retrospectively analyzed. According to the type of primary diseases, 182 recipients were divided into the benign group (n=135) and hepatocellular carcinoma (liver cancer) group (n=47). Perioperative conditions, 1- and 3-year survival rate of the recipients were statistically compared between two groups. Clinical prognosis and the incidence of postoperative complications of the recipients were summarized. Postoperative complications mainly included early allograft dysfunction (EAD), vascular complications, acute kidney injury (AKI), pulmonary infection, acute rejection, cytomegalovirus (CMV) infection and billiary tract complication. Results No statistical significance was identified in the anhepatic phase, operation time and length of intensive care unit (ICU) stay between two groups (all P>0.05). The 1-year survival rates of the 182 recipients and grafts were 93.1%, and 84.9% for the 3-year survival rates. In the benign group, the 1- and 3-year survival rates of the recipients were 92.5% and 88.1%. In the liver cancer group, the 1-year survival rate of the recipients was 95%, 91% for the disease-free survival rate, and 78% for the 3-year survival rate, respectively. No statistical significance was noted in the overall survival rate of the recipients between two groups (P=0.879). In terms of postoperative complications, billiary tract complications occurred in 26 patients, vascular complications in 14, AKI in 34, pulmonary infection in 22, acute rejection in 11, EAD in 11 and CMV infection in 10. The incidence of postoperative billiary tract complications in patients with T-tube insertion was significantly lower than that in their counterparts without T-tube insertion (8% vs. 19%, P<0.05). Conclusions Liver transplantation from DCD is an efficacious treatment for end-stage liver diseases and liver cancer, which yields relatively high short-term clinical efficacy.
