Controlled non-heart-beating donor liver transplantation: a successful single center experience, with topic update

Area of Science:

• Transplantation immunology
• Organ procurement strategies
• Surgical innovation

Background:

• Critical shortage of transplantable organs necessitates exploring unconventional donor sources.
• Successful implementation of controlled non-heart-beating donor (NHBD) liver transplantation is reported.

Purpose of the Study:

• To evaluate the feasibility and outcomes of liver transplantation using organs from controlled non-heart-beating donors.
• To assess the safety and efficacy of NHBD liver transplantation in expanding the donor pool.

Main Methods:

• Organs were recovered from controlled NHBDs following withdrawal of life support and death determination.
• Rapid aortic cannulation and organ procurement were performed after cessation of ventilation.
• Liver and kidney recovery procedures were standardized for NHBDs.

Main Results:

• Controlled NHBDs provided 5% of hepatic allografts during the study period.
• All patients (n=8) and grafts achieved 100% survival at 18 months post-transplant.
• No major complications such as primary nonfunction, thrombosis, or serious infection were observed.

Conclusions:

• NHBDs significantly and safely expand the organ donor pool for liver transplantation.
• Rapid procurement by skilled surgical teams is crucial for successful NHBD liver transplantation.
• Liberalizing acceptance criteria for NHBD livers, with refined ethics, is warranted.