PURPOSE OF REVIEW: Liver transplantation following donation after cardiac death (DCD) continues to be a subject for heated debate. Opinion is divided in the literature as to who benefits the most from receiving a liver from a DCD donor. This review will focus on some important questions regarding the outcome of transplantation and the selection and matching of donor and recipient. RECENT FINDINGS: Liver transplantation with an organ from a donor after cardiac death is becoming an accepted way to treat patients on the waiting list with end-stage liver disease. However, there are still some major issues to address such as ischemic-type biliary lesions, retransplantation rates, criteria for donor and patient selection and whether conversion of donation after brain death to DCD exists. Accepting a DCD liver has the potential for reduced recipient quality of life after transplant. Death on the waiting list must be balanced against the inherent risks of a DCD liver. SUMMARY: Success of liver transplantation is mostly measured as graft and patient survival. DCD liver transplantation is a potential tool to decrease mortality on the waiting list. Careful selection and matching of donor organ and recipient can lead to good outcomes. However, ischemic-type biliary lesions after DCD liver transplantation remain an important obstacle to overcome and have a serious impact on quality of life after transplantation.
PURPOSE OF REVIEW: Liver transplantation following donation after cardiac death (DCD) continues to be a subject for heated debate. Opinion is divided in the literature as to who benefits the most from receiving a liver from a DCD donor. This review will focus on some important questions regarding the outcome of transplantation and the selection and matching of donor and recipient. RECENT FINDINGS: Liver transplantation with an organ from a donor after cardiac death is becoming an accepted way to treat patients on the waiting list with end-stage liver disease. However, there are still some major issues to address such as ischemic-type biliary lesions, retransplantation rates, criteria for donor and patient selection and whether conversion of donation after brain death to DCD exists. Accepting a DCD liver has the potential for reduced recipient quality of life after transplant. Death on the waiting list must be balanced against the inherent risks of a DCD liver. SUMMARY: Success of liver transplantation is mostly measured as graft and patient survival. DCD liver transplantation is a potential tool to decrease mortality on the waiting list. Careful selection and matching of donor organ and recipient can lead to good outcomes. However, ischemic-type biliary lesions after DCD liver transplantation remain an important obstacle to overcome and have a serious impact on quality of life after transplantation.
Authors: Emre A Eren; Nicholas Latchana; Eliza Beal; Don Hayes; Bryan Whitson; Sylvester M Black Journal: Exp Clin Transplant Date: 2016-10 Impact factor: 0.945