Donations After Circulatory Death in Liver Transplant

被引:32
作者
Eren, Emre A. [1 ,5 ]
Latchana, Nicholas [1 ]
Beal, Eliza [1 ,5 ]
Hayes, Don, Jr. [2 ,3 ,6 ]
Whitson, Bryan [4 ,5 ]
Black, Sylvester M. [1 ,5 ]
机构
[1] Ohio State Univ, Dept Surg, Div Transplantat, Wexner Med Ctr, Columbus, OH 43210 USA
[2] Ohio State Univ, Dept Pediat, Wexner Med Ctr, Columbus, OH 43210 USA
[3] Ohio State Univ, Dept Internal Med, Wexner Med Ctr, Columbus, OH 43210 USA
[4] Ohio State Univ, Dept Surg, Wexner Med Ctr, Div Cardiac Surg, Columbus, OH 43210 USA
[5] Ohio State Univ, Wexner Med Ctr, Collaborat Organ Perfus Protect Engn & Regenerat, Columbus, OH 43210 USA
[6] Nationwide Childrens Hosp, Sect Pulm Med, Columbus, OH USA
关键词
Donor selection; Tissue and organ procurement; SUBNORMOTHERMIC MACHINE PERFUSION; CONTROLLED NONHEARTBEATING DONORS; SINGLE-CENTER EXPERIENCE; BILE-DUCT INJURY; CARDIAC DEATH; BILIARY COMPLICATIONS; ISCHEMIC CHOLANGIOPATHY; KIDNEY-TRANSPLANTATION; GRAFT-SURVIVAL; ORGAN DONATION;
D O I
10.6002/ect.2015.0256
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
The supply of liver grafts for treatment of end-stage liver disease continues to fall short of ongoing demands. Currently, most liver transplants originate from donations after brain death. Enhanced utilization of the present resources is prudent to address the needs of the population. Donation after circulatory or cardiac death is a mechanism whereby the availability of organs can be expanded. Donations after circulatory death pose unique challenges given their exposure to warm ischemia. Technical principles of donations after circulatory death procurement and pertinent studies investigating patient outcomes, graft outcomes, and complications are highlighted in this review. We also review associated risk factors to suggest potential avenues to achieve improved outcomes and reduced complications. Future considerations and alternative techniques of organ preservation are discussed, which may suggest novel strategies to enhance preservation and donor expansion through the use of marginal donors. Ultimately, without effective measures to bolster organ supply, donations after circulatory death should remain a consideration; however, an understanding of inherent risks and limitations is necessary.
引用
收藏
页码:463 / 470
页数:8
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