French survey of the first three-years of liver transplantation activity from uncontrolled donors deceased after cardiac death

Objective: To assess the first three years of French activity related to liver transplantation from uncontrolled donation after cardiac death (uDCD). Study design: Prospective and observational study in the three active centres authorized by the French Biomedicine Agency. Patients and methods: All patients deceased between 2010 and 2012 after an uncontrolled cardiac arrest admitted to one of three centres (Pitie-Salpetriere, Saint-Louis or Bicetre hospitals, AP-HP, Paris, France) and potentially eligible for liver recovery were included. Abdominal normothermic oxygenated recirculation (ANOR) was used for graft preservation. Results: One hundred twenty-six potential uDCD donors were identified as eligible for liver recovery after hospital admission. The main causes of organ recovery failure were technical failure related to ANOR (29 patients, 23%), refusal of consent (39 patients, 31% of potential uDCD donors and 40% of asked relatives) and abnormal hepatic transaminases up to 200 UI. L-1 during ANOR (24 patients, 19%). Finally, 11 livers were transplanted. Process efficiency was 9% [95% CI: 4-15%]. One-year recipient survival was 82%, [95% CI: 48-98%] and one-year graft survival was 64% [95% CI: 31-89%]. Conclusion: Liver transplantation from uDCD donors is achievable in France, despite low process efficiency. (C) 2015 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.