Immunosuppression in Donation After Circulatory Death Liver Transplantation: Can Induction Modify Graft Survival?

2020 ◽  
Vol 26 (9) ◽  
pp. 1154-1166
Author(s):  
Kevin Ig‐Izevbekhai ◽  
David S. Goldberg ◽  
Seth J. Karp ◽  
David P. Foley ◽  
Peter L. Abt
Keyword(s):  
Liver Transplantation ◽  
Graft Survival ◽  
Donation After Circulatory Death ◽  
Circulatory Death

Donation after Circulatory Death: Potential Mechanisms of Injury and Preventative Strategies

2020 ◽  
Vol 40 (03) ◽  
pp. 256-263
Author(s):  
Kristopher P. Croome
Keyword(s):  
Liver Transplantation ◽  
Clinical Practice ◽  
Learning Curve ◽  
Graft Survival ◽  
Biliary Complications ◽  
Donation After Circulatory Death ◽  
Concise Review ◽  
Number Of Patients ◽  
Circulatory Death

AbstractDonation after circulatory death (DCD) donors represent a potential means to help address the disparity between the number of patients awaiting liver transplantation (LT) and the availability of donor livers. While initial enthusiasm for DCD LT was high in the early 2000s, early reports of high rates of biliary complications and inferior graft survival resulted in reluctance among many transplant centers to use DCD liver grafts. As with all innovations in transplant practice, there is undoubtedly a learning curve associated with the optimal utilization of liver grafts from DCD donors. More contemporary data has demonstrated that results with DCD LT are improving and the number of DCD LT performed annually has been steadily increasing. In this concise review, potential mechanisms of injury for DCD livers are discussed along with strategies that have been employed in clinical practice to improve DCD LT outcomes.

scholarly journals Role of donor hemodynamic trajectory in determining graft survival in liver transplantation from donation after circulatory death donors

2016 ◽  
Vol 22 (11) ◽  
pp. 1469-1481 ◽  
Author(s):  
Daniel J. Firl ◽  
Koji Hashimoto ◽  
Colin O'Rourke ◽  
Teresa Diago-Uso ◽  
Masato Fujiki ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Graft Survival ◽  
Donation After Circulatory Death ◽  
Circulatory Death

scholarly journals Advantages and Limitations of Clinical Scores for Donation After Circulatory Death Liver Transplantation

2022 ◽  
Vol 8 ◽  
Author(s):  
Raphael P. H. Meier ◽  
Yvonne Kelly ◽  
Seiji Yamaguchi ◽  
Hillary J. Braun ◽  
Tyler Lunow-Luke ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Graft Survival ◽  
San Francisco ◽  
Disease Model ◽  
Scoring Systems ◽  
Risk Scores ◽  
Donation After Circulatory Death ◽  
Ischemia Time ◽  
Circulatory Death

Background: Scoring systems have been proposed to select donation after circulatory death (DCD) donors and recipients for liver transplantation (LT). We hypothesized that complex scoring systems derived in large datasets might not predict outcomes locally.Methods: Based on 1-year DCD-LT graft survival predictors in multivariate logistic regression models, we designed, validated, and compared a simple index using the University of California, San Francisco (UCSF) cohort (n = 136) and a universal-comprehensive (UC)-DCD score using the United Network for Organ Sharing (UNOS) cohort (n = 5,792) to previously published DCD scoring systems.Results: The total warm ischemia time (WIT)-index included donor WIT (dWIT) and hepatectomy time (dHep). The UC-DCD score included dWIT, dHep, recipient on mechanical ventilation, transjugular-intrahepatic-portosystemic-shunt, cause of liver disease, model for end-stage liver disease, body mass index, donor/recipient age, and cold ischemia time. In the UNOS cohort, the UC-score outperformed all previously published scores in predicting DCD-LT graft survival (AUC: 0.635 vs. ≤0.562). In the UCSF cohort, the total WIT index successfully stratified survival and biliary complications, whereas other scores did not.Conclusion: DCD risk scores generated in large cohorts provide general guidance for safe recipient/donor selection, but they must be tailored based on non-/partially-modifiable local circumstances to expand DCD utilization.

Uncontrolled donation after circulatory death and liver transplantation: evidence and unresolved issues

2020 ◽  
Vol 86 (2) ◽  
Author(s):  
Chiara Lazzeri ◽  
Manuela Bonizzoli ◽  
Fabio Marra ◽  
Paolo Muiesan ◽  
Davide Ghinolfi ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Donation After Circulatory Death ◽  
Circulatory Death

scholarly journals Liver Transplantation in Children Using Organ Donation After Circulatory Death

JAMA Surgery ◽  
2014 ◽  
Vol 149 (1) ◽  
pp. 77 ◽  
Author(s):  
Johnny C. Hong ◽  
Robert Venick ◽  
Hasan Yersiz ◽  
Prawat Kositamongkol ◽  
Fady M. Kaldas ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Organ Donation ◽  
Donation After Circulatory Death ◽  
Circulatory Death
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