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Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
Liver transplantation using non-heart-beating donors: Belgian experience
D Monbaliu1, F Van Gelder, R Troisi
1Abdominal Transplant Surgery Department, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium. Diethard.Monbaliu@uz.kuleuven.ac.be
Transplantation Proceedings
|June 21, 2007
Summary
Non-heart-beating donor liver transplantation (NHBD-LT) shows acceptable survival rates, but careful donor and recipient selection is crucial. NHBD-LT grafts face higher risks of ischemic injury and biliary complications, necessitating short ischemia times.
Area of Science:
- Hepatology
- Transplant Surgery
- Organ Donation
Background:
- Rising mortality on liver transplantation (OLT) waiting lists necessitates expanded donor pools.
- Historically, non-heart-beating donors (NHBD) were excluded from OLT due to concerns over graft nonfunction and biliary issues.
- Recent evidence suggests NHBD-OLT feasibility with minimized warm ischemia.
Purpose of the Study:
- To evaluate the outcomes of NHBD-OLT in Belgium.
- To characterize graft and patient survival rates following NHBD-OLT.
- To identify risk factors associated with NHBD-OLT complications.
Main Methods:
- A survey was distributed to all Belgian OLT centers.
- Data collected on liver grafts procured from NHBD between January 2003 and November 2005.
- Analysis of donor demographics, ischemia times, and post-transplant outcomes.
Main Results:
- Sixteen NHBD livers were transplanted, with mean donor age 48.8 years.
- Mean cold ischemia time was 7 hours 15 minutes; no primary graft nonfunction (PNF) observed.
- Biliary complications occurred in 6 patients; graft survival was 62.5%, patient survival 81.3%.
Conclusions:
- NHBD-LT demonstrated acceptable graft and patient survivals in this Belgian cohort.
- NHBD liver grafts are susceptible to ischemic injury and biliary complications.
- Careful patient selection, avoidance of additional donor risks, and short ischemia times are recommended for NHBD-OLT.
