Donation after circulatory death liver transplantation: An in‐depth analysis and propensity score–matched comparison
Background Careful donor‐recipient matching and reduced ischemia times have improved outcomes following donation after circulatory death (DCD) liver transplantation (LT). This study examines a single‐center experience with DCD LT including high‐acuity and hospitalized recipients. Methods DCD LT outc...
Gespeichert in:
| Veröffentlicht in: | Clinical transplantation 2021-06, Vol.35 (6), p.e14304-n/a, Article 14304 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | n/a |
|---|---|
| container_issue | 6 |
| container_start_page | e14304 |
| container_title | Clinical transplantation |
| container_volume | 35 |
| creator | Hobeika, Mark J. Saharia, Ashish Mobley, Constance M. Menser, Terri Nguyen, Duc T. Graviss, Edward A. McMillan, Robert R. Podder, Hemangshu Nolte Fong, Joy V. Jones, Stephen L. Yi, Stephanie G. Elshawwaf, Mahmoud Gaber, Ahmed O. Ghobrial, Rafik M. |
| description | Background
Careful donor‐recipient matching and reduced ischemia times have improved outcomes following donation after circulatory death (DCD) liver transplantation (LT). This study examines a single‐center experience with DCD LT including high‐acuity and hospitalized recipients.
Methods
DCD LT outcomes were compared to a propensity score–matched (PSM) donation after brain death (DBD) LT cohort (1:4); 32 DCD LT patients and 128 PSM DBD LT patients transplanted from 2008 to 2018 were included. Analyses included Kaplan‐Meier estimates and Cox proportional hazards models examining patient and graft survival.
Results
Median MELD score in the DCD LT cohort was 22, with median MELD of 27 for DCD LT recipients with decompensated cirrhosis. No difference in mortality or graft loss was found (p |
| doi_str_mv | 10.1111/ctr.14304 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1111_ctr_14304</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2507731375</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3254-141ed783832e2c53117fa0a5913ee7f800349b37dd86f7043ba605cd6e7bfb3c3</originalsourceid><addsrcrecordid>eNqNkc1u1TAQhS0EopfCghdAXoLQbe1MHCfsqvArVUJCZR059kQ1SuxgO4Xs-ghIvGGfBLe5dIfEbOZo9M3o-JiQ55yd8FynOoUTXgIrH5Adh6bZM8aLh2THGlZkXcEReRLjtzyteCUekyMA2RSN5Dvy8613KlnvqBoSBqpt0Muokg8rNajSJR3tVZ6noFycR-XSHf2Gnjlq3c31L4NzhpRT4xptzMLQOfgZXbRppVH7gDfXvyeV9CUaqv00q2Cjd0_Jo0GNEZ8d-jH5-v7dRftxf_75w6f27HyvoRDlnpccjayhhgILLYBzOSimRMMBUQ41Y1A2PUhj6mqQrIReVUxoU6Hshx40HJOX293s6vuCMXWTjRrH_BT0S-wKwaQEDlJk9NWG6uBjDDh0c7CTCmvHWXcbdJeD7u6CzuyLw9mln9Dck3-TzUC9AT-w90PUFp3Ge4zd_kojBC-zYry1W6ytX1zKq6__fzXTpwfajrj-23LXXnzZvP8BVeWsUw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2507731375</pqid></control><display><type>article</type><title>Donation after circulatory death liver transplantation: An in‐depth analysis and propensity score–matched comparison</title><source>Access via Wiley Online Library</source><source>Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Hobeika, Mark J. ; Saharia, Ashish ; Mobley, Constance M. ; Menser, Terri ; Nguyen, Duc T. ; Graviss, Edward A. ; McMillan, Robert R. ; Podder, Hemangshu ; Nolte Fong, Joy V. ; Jones, Stephen L. ; Yi, Stephanie G. ; Elshawwaf, Mahmoud ; Gaber, Ahmed O. ; Ghobrial, Rafik M.</creator><creatorcontrib>Hobeika, Mark J. ; Saharia, Ashish ; Mobley, Constance M. ; Menser, Terri ; Nguyen, Duc T. ; Graviss, Edward A. ; McMillan, Robert R. ; Podder, Hemangshu ; Nolte Fong, Joy V. ; Jones, Stephen L. ; Yi, Stephanie G. ; Elshawwaf, Mahmoud ; Gaber, Ahmed O. ; Ghobrial, Rafik M.</creatorcontrib><description>Background
Careful donor‐recipient matching and reduced ischemia times have improved outcomes following donation after circulatory death (DCD) liver transplantation (LT). This study examines a single‐center experience with DCD LT including high‐acuity and hospitalized recipients.
Methods
DCD LT outcomes were compared to a propensity score–matched (PSM) donation after brain death (DBD) LT cohort (1:4); 32 DCD LT patients and 128 PSM DBD LT patients transplanted from 2008 to 2018 were included. Analyses included Kaplan‐Meier estimates and Cox proportional hazards models examining patient and graft survival.
Results
Median MELD score in the DCD LT cohort was 22, with median MELD of 27 for DCD LT recipients with decompensated cirrhosis. No difference in mortality or graft loss was found (p < .05) between DCD LT and PSM DBD LT at 3 years post‐transplant, nor was DCD an independent risk factor for patient or graft survival. Post‐LT severe acute kidney injury was similar in both groups. Ischemic‐type biliary lesions (ITBL) occurred in 6.3% (n = 2) of DCD LT recipients, resulting in 1 graft loss and 1 death.
Conclusion
This study supports that DCD LT outcomes can be similar to DBD LT, with a low rate of ITBL, in a cohort including high‐acuity recipients. Strict donor selection criteria, ischemia time minimization, and avoiding futile donor/recipient combinations are essential considerations.</description><identifier>ISSN: 0902-0063</identifier><identifier>EISSN: 1399-0012</identifier><identifier>DOI: 10.1111/ctr.14304</identifier><identifier>PMID: 33792971</identifier><language>eng</language><publisher>HOBOKEN: Wiley</publisher><subject>donation after circulatory death ; donors and donation ; Life Sciences & Biomedicine ; liver allograft function ; Science & Technology ; Surgery ; Transplantation</subject><ispartof>Clinical transplantation, 2021-06, Vol.35 (6), p.e14304-n/a, Article 14304</ispartof><rights>2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>6</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000639551400001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c3254-141ed783832e2c53117fa0a5913ee7f800349b37dd86f7043ba605cd6e7bfb3c3</citedby><cites>FETCH-LOGICAL-c3254-141ed783832e2c53117fa0a5913ee7f800349b37dd86f7043ba605cd6e7bfb3c3</cites><orcidid>0000-0003-1024-5813 ; 0000-0003-3095-2590 ; 0000-0002-5059-4404 ; 0000-0002-7444-7097</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fctr.14304$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fctr.14304$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,39263,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33792971$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hobeika, Mark J.</creatorcontrib><creatorcontrib>Saharia, Ashish</creatorcontrib><creatorcontrib>Mobley, Constance M.</creatorcontrib><creatorcontrib>Menser, Terri</creatorcontrib><creatorcontrib>Nguyen, Duc T.</creatorcontrib><creatorcontrib>Graviss, Edward A.</creatorcontrib><creatorcontrib>McMillan, Robert R.</creatorcontrib><creatorcontrib>Podder, Hemangshu</creatorcontrib><creatorcontrib>Nolte Fong, Joy V.</creatorcontrib><creatorcontrib>Jones, Stephen L.</creatorcontrib><creatorcontrib>Yi, Stephanie G.</creatorcontrib><creatorcontrib>Elshawwaf, Mahmoud</creatorcontrib><creatorcontrib>Gaber, Ahmed O.</creatorcontrib><creatorcontrib>Ghobrial, Rafik M.</creatorcontrib><title>Donation after circulatory death liver transplantation: An in‐depth analysis and propensity score–matched comparison</title><title>Clinical transplantation</title><addtitle>CLIN TRANSPLANT</addtitle><addtitle>Clin Transplant</addtitle><description>Background
Careful donor‐recipient matching and reduced ischemia times have improved outcomes following donation after circulatory death (DCD) liver transplantation (LT). This study examines a single‐center experience with DCD LT including high‐acuity and hospitalized recipients.
Methods
DCD LT outcomes were compared to a propensity score–matched (PSM) donation after brain death (DBD) LT cohort (1:4); 32 DCD LT patients and 128 PSM DBD LT patients transplanted from 2008 to 2018 were included. Analyses included Kaplan‐Meier estimates and Cox proportional hazards models examining patient and graft survival.
Results
Median MELD score in the DCD LT cohort was 22, with median MELD of 27 for DCD LT recipients with decompensated cirrhosis. No difference in mortality or graft loss was found (p < .05) between DCD LT and PSM DBD LT at 3 years post‐transplant, nor was DCD an independent risk factor for patient or graft survival. Post‐LT severe acute kidney injury was similar in both groups. Ischemic‐type biliary lesions (ITBL) occurred in 6.3% (n = 2) of DCD LT recipients, resulting in 1 graft loss and 1 death.
Conclusion
This study supports that DCD LT outcomes can be similar to DBD LT, with a low rate of ITBL, in a cohort including high‐acuity recipients. Strict donor selection criteria, ischemia time minimization, and avoiding futile donor/recipient combinations are essential considerations.</description><subject>donation after circulatory death</subject><subject>donors and donation</subject><subject>Life Sciences & Biomedicine</subject><subject>liver allograft function</subject><subject>Science & Technology</subject><subject>Surgery</subject><subject>Transplantation</subject><issn>0902-0063</issn><issn>1399-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><recordid>eNqNkc1u1TAQhS0EopfCghdAXoLQbe1MHCfsqvArVUJCZR059kQ1SuxgO4Xs-ghIvGGfBLe5dIfEbOZo9M3o-JiQ55yd8FynOoUTXgIrH5Adh6bZM8aLh2THGlZkXcEReRLjtzyteCUekyMA2RSN5Dvy8613KlnvqBoSBqpt0Muokg8rNajSJR3tVZ6noFycR-XSHf2Gnjlq3c31L4NzhpRT4xptzMLQOfgZXbRppVH7gDfXvyeV9CUaqv00q2Cjd0_Jo0GNEZ8d-jH5-v7dRftxf_75w6f27HyvoRDlnpccjayhhgILLYBzOSimRMMBUQ41Y1A2PUhj6mqQrIReVUxoU6Hshx40HJOX293s6vuCMXWTjRrH_BT0S-wKwaQEDlJk9NWG6uBjDDh0c7CTCmvHWXcbdJeD7u6CzuyLw9mln9Dck3-TzUC9AT-w90PUFp3Ge4zd_kojBC-zYry1W6ytX1zKq6__fzXTpwfajrj-23LXXnzZvP8BVeWsUw</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Hobeika, Mark J.</creator><creator>Saharia, Ashish</creator><creator>Mobley, Constance M.</creator><creator>Menser, Terri</creator><creator>Nguyen, Duc T.</creator><creator>Graviss, Edward A.</creator><creator>McMillan, Robert R.</creator><creator>Podder, Hemangshu</creator><creator>Nolte Fong, Joy V.</creator><creator>Jones, Stephen L.</creator><creator>Yi, Stephanie G.</creator><creator>Elshawwaf, Mahmoud</creator><creator>Gaber, Ahmed O.</creator><creator>Ghobrial, Rafik M.</creator><general>Wiley</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1024-5813</orcidid><orcidid>https://orcid.org/0000-0003-3095-2590</orcidid><orcidid>https://orcid.org/0000-0002-5059-4404</orcidid><orcidid>https://orcid.org/0000-0002-7444-7097</orcidid></search><sort><creationdate>202106</creationdate><title>Donation after circulatory death liver transplantation: An in‐depth analysis and propensity score–matched comparison</title><author>Hobeika, Mark J. ; Saharia, Ashish ; Mobley, Constance M. ; Menser, Terri ; Nguyen, Duc T. ; Graviss, Edward A. ; McMillan, Robert R. ; Podder, Hemangshu ; Nolte Fong, Joy V. ; Jones, Stephen L. ; Yi, Stephanie G. ; Elshawwaf, Mahmoud ; Gaber, Ahmed O. ; Ghobrial, Rafik M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3254-141ed783832e2c53117fa0a5913ee7f800349b37dd86f7043ba605cd6e7bfb3c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>donation after circulatory death</topic><topic>donors and donation</topic><topic>Life Sciences & Biomedicine</topic><topic>liver allograft function</topic><topic>Science & Technology</topic><topic>Surgery</topic><topic>Transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hobeika, Mark J.</creatorcontrib><creatorcontrib>Saharia, Ashish</creatorcontrib><creatorcontrib>Mobley, Constance M.</creatorcontrib><creatorcontrib>Menser, Terri</creatorcontrib><creatorcontrib>Nguyen, Duc T.</creatorcontrib><creatorcontrib>Graviss, Edward A.</creatorcontrib><creatorcontrib>McMillan, Robert R.</creatorcontrib><creatorcontrib>Podder, Hemangshu</creatorcontrib><creatorcontrib>Nolte Fong, Joy V.</creatorcontrib><creatorcontrib>Jones, Stephen L.</creatorcontrib><creatorcontrib>Yi, Stephanie G.</creatorcontrib><creatorcontrib>Elshawwaf, Mahmoud</creatorcontrib><creatorcontrib>Gaber, Ahmed O.</creatorcontrib><creatorcontrib>Ghobrial, Rafik M.</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hobeika, Mark J.</au><au>Saharia, Ashish</au><au>Mobley, Constance M.</au><au>Menser, Terri</au><au>Nguyen, Duc T.</au><au>Graviss, Edward A.</au><au>McMillan, Robert R.</au><au>Podder, Hemangshu</au><au>Nolte Fong, Joy V.</au><au>Jones, Stephen L.</au><au>Yi, Stephanie G.</au><au>Elshawwaf, Mahmoud</au><au>Gaber, Ahmed O.</au><au>Ghobrial, Rafik M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Donation after circulatory death liver transplantation: An in‐depth analysis and propensity score–matched comparison</atitle><jtitle>Clinical transplantation</jtitle><stitle>CLIN TRANSPLANT</stitle><addtitle>Clin Transplant</addtitle><date>2021-06</date><risdate>2021</risdate><volume>35</volume><issue>6</issue><spage>e14304</spage><epage>n/a</epage><pages>e14304-n/a</pages><artnum>14304</artnum><issn>0902-0063</issn><eissn>1399-0012</eissn><abstract>Background
Careful donor‐recipient matching and reduced ischemia times have improved outcomes following donation after circulatory death (DCD) liver transplantation (LT). This study examines a single‐center experience with DCD LT including high‐acuity and hospitalized recipients.
Methods
DCD LT outcomes were compared to a propensity score–matched (PSM) donation after brain death (DBD) LT cohort (1:4); 32 DCD LT patients and 128 PSM DBD LT patients transplanted from 2008 to 2018 were included. Analyses included Kaplan‐Meier estimates and Cox proportional hazards models examining patient and graft survival.
Results
Median MELD score in the DCD LT cohort was 22, with median MELD of 27 for DCD LT recipients with decompensated cirrhosis. No difference in mortality or graft loss was found (p < .05) between DCD LT and PSM DBD LT at 3 years post‐transplant, nor was DCD an independent risk factor for patient or graft survival. Post‐LT severe acute kidney injury was similar in both groups. Ischemic‐type biliary lesions (ITBL) occurred in 6.3% (n = 2) of DCD LT recipients, resulting in 1 graft loss and 1 death.
Conclusion
This study supports that DCD LT outcomes can be similar to DBD LT, with a low rate of ITBL, in a cohort including high‐acuity recipients. Strict donor selection criteria, ischemia time minimization, and avoiding futile donor/recipient combinations are essential considerations.</abstract><cop>HOBOKEN</cop><pub>Wiley</pub><pmid>33792971</pmid><doi>10.1111/ctr.14304</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0003-1024-5813</orcidid><orcidid>https://orcid.org/0000-0003-3095-2590</orcidid><orcidid>https://orcid.org/0000-0002-5059-4404</orcidid><orcidid>https://orcid.org/0000-0002-7444-7097</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0902-0063 |
| ispartof | Clinical transplantation, 2021-06, Vol.35 (6), p.e14304-n/a, Article 14304 |
| issn | 0902-0063 1399-0012 |
| language | eng |
| recordid | cdi_crossref_primary_10_1111_ctr_14304 |
| source | Access via Wiley Online Library; Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /> |
| subjects | donation after circulatory death donors and donation Life Sciences & Biomedicine liver allograft function Science & Technology Surgery Transplantation |
| title | Donation after circulatory death liver transplantation: An in‐depth analysis and propensity score–matched comparison |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-11T11%3A57%3A06IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Donation%20after%20circulatory%20death%20liver%20transplantation:%20An%20in%E2%80%90depth%20analysis%20and%20propensity%20score%E2%80%93matched%20comparison&rft.jtitle=Clinical%20transplantation&rft.au=Hobeika,%20Mark%20J.&rft.date=2021-06&rft.volume=35&rft.issue=6&rft.spage=e14304&rft.epage=n/a&rft.pages=e14304-n/a&rft.artnum=14304&rft.issn=0902-0063&rft.eissn=1399-0012&rft_id=info:doi/10.1111/ctr.14304&rft_dat=%3Cproquest_cross%3E2507731375%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2507731375&rft_id=info:pmid/33792971&rfr_iscdi=true |