AI Article Synopsis
- The study examines the outcomes of liver transplants using allografts from donors after cardiac death (DCD) between 2006 and 2016, aiming to assess survival rates and complications.
- Results showed a one-year patient survival rate of 90.6% and a five-year survival rate of 69.8%, with biliary complications arising in 30.2% of patients in the first year, particularly ischemic cholangiopathy.
- The research indicates that while survival outcomes for DCD transplants have improved over time, biliary complications persist as a major concern, necessitating closer monitoring for patients experiencing such complications during their initial hospital stay.
Article Abstract
Utilizing allografts from donors after cardiac death (DCD) has improved organ availability, and DCD livers comprise a growing proportion of transplantations. However, it has been suggested that DCD transplantations have worse outcomes. We aimed to characterize outcomes in a large cohort of DCD transplantations, identify trends in outcomes over time, and identify factors associated with the development of biliary complications. Design: We conducted an observational retrospective cohort study of patients receiving DCD liver allografts within a large academic teaching hospital with a high transplantation volume. Consecutive patients who underwent Type III DCD liver transplantation from 2006-2016 were included in our cohort. Re-transplantations and multi-organ transplant recipients were excluded. Ninety-six type III DCD transplantations occurred between 2006-2016. We report a 1one-year patient survival of 90.6% (87) and a 5five-year patient survival of 69.8% (67). Twenty-nine (30.2%) patients experienced any biliary complication in the first year following discharge, with 17 (17.7%) experiencing ischemic cholangiopathy. Five-year patient (P = 0.04) and graft (P = 0.005) survival improved over time. Post-operative biliary complications experienced during index admission and prior to discharge were found to be associated with the development of biliary complications (P = 0.005) and ischemic cholangiopathy (P = 0.01) following discharge. Our data suggested that outcomes using DCD allografts have improved, however biliary complications remain a significant issue in DCD transplantation. Patients who experienced post-operative biliary complications during index admission may require more frequent screening to allow the initiation of earlier treatment for biliary complications.
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| http://dx.doi.org/10.1177/15269248221107039 | DOI Listing |
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