Selected liver grafts from donation after circulatory death can be safely used for retransplantation - a multicenter retrospective study

Marjolein van Reeven, Otto B. van Leeuwen, Danny van der Helm, Sarwa Darwish Murad, Aad P. van den Berg, Bart van Hoek, Ian P. J. Alwayn, Wojciech G. Polak, Robert J. Porte*

*Corresponding author for this work

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Abstract

Due to the growing number of liver transplantations (LTs), there is an increasing number of patients requiring retransplantation (reLT). Data on the use of grafts from extended criteria donors (ECD), especially donation after circulatory death (DCD), for reLT are lacking. We aimed to assess the outcome of patients undergoing reLT using a DCD graft in the Netherlands between 2001 and July 2018. Propensity score matching was used to match each DCD-reLT with three DBD-reLT cases. Primary outcomes were patient and graft survival. Secondary outcome was the incidence of biliary complications, especially nonanastomotic strictures (NAS). 21 DCD-reLT were compared with 63 matched DBD-reLTs. Donors in the DCD-reLT group had a significantly lower BMI (22.4 vs. 24.7 kg/m(2), P-value = 0.02). Comparison of recipient demographics and ischemia times yielded no significant differences. Patient and graft survival rates were comparable between the two groups. However, the occurrence of nonanastomotic strictures after DCD-reLT was significantly higher (38.1% vs. 12.7%, P-value = 0.02). ReLT with DCD grafts does not result in inferior patient and graft survival compared with DBD grafts in selected patients. Therefore, DCD liver grafts should not routinely be declined for patients awaiting reLT.

Original languageEnglish
Pages (from-to)667-674
Number of pages8
JournalTransplant International
Volume33
Issue number6
DOIs
Publication statusPublished - Jun-2020

Keywords

  • deceased donors
  • donation after circulatory death
  • graft outcomes
  • liver retransplantation
  • liver transplantation
  • patient outcomes
  • NONANASTOMOTIC BILIARY STRICTURES
  • TRANSPLANTATION
  • PERFUSION
  • DONORS
  • RISK

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