Long-term results after transplantation of pediatric liver grafts from donation after circulatory death donors

Rianne van Rijn; Pieter E. R. Hoogland; Frank Lehner; Ernest L. W. van Heurn; Robert J. Porte

doi:10.1371/journal.pone.0175097

Long-term results after transplantation of pediatric liver grafts from donation after circulatory death donors

Rianne van Rijn, Pieter E. R. Hoogland, Frank Lehner, Ernest L. W. van Heurn, Robert J. Porte^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background

Liver grafts from donation after circulatory death (DCD) donors are increasingly accepted as an extension of the organ pool for transplantation. There is little data on the outcome of liver transplantation with DCD grafts from a pediatric donor. The objective of this study was to assess the outcome of liver transplantation with pediatric DCD grafts and to compare this with the outcome after transplantation of livers from pediatric donation after brain death (DBD) donors.

Method

All transplantations performed with a liver from a pediatric donor (

Results

In total, 74 liver transplantations with pediatric grafts were performed; twenty (27%) DCD and 54 (73%) DBD. The median donor warm ischemia time (DWIT) was 24 min (range 15-43 min). Patient survival rate at 10 years was 78% for recipients of DCD grafts and 89% for DBD grafts (p = 0.32). Graft survival rate at 10 years was 65% in recipients of DCD versus 76% in DBD grafts (p = 0.20). If donor livers in this study would have been rejected for transplantation when the DWIT >= 30 min (n = 4), the 10-year graft survival rate would have been 81% after DCD transplantation. The rate of non-anastomotic biliary strictures was 5% in DCD and 4% in DBD grafts (p = 1.00). Other complication rates were also similar between both groups.

Conclusions

Transplantation of livers from pediatric DCD donors results in good long-term outcome especially when the DWIT is kept

Original language	English
Article number	e0175097
Number of pages	12
Journal	PLOS ONE
Volume	12
Issue number	4
DOIs	https://doi.org/10.1371/journal.pone.0175097
Publication status	Published - 20 Apr 2017

Keywords

SINGLE-CENTER EXPERIENCE
HEART-BEATING DONORS
CARDIAC DEATH
BILIARY STRICTURES
ORGAN DONATION
CHILDREN
COMPLICATIONS
INCREASE
FAILURE
INJURY

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Cite this

@article{a1585b5b1d524bac94b20c0524a8dca4,

title = "Long-term results after transplantation of pediatric liver grafts from donation after circulatory death donors",

abstract = "BackgroundLiver grafts from donation after circulatory death (DCD) donors are increasingly accepted as an extension of the organ pool for transplantation. There is little data on the outcome of liver transplantation with DCD grafts from a pediatric donor. The objective of this study was to assess the outcome of liver transplantation with pediatric DCD grafts and to compare this with the outcome after transplantation of livers from pediatric donation after brain death (DBD) donors.MethodAll transplantations performed with a liver from a pediatric donor (ResultsIn total, 74 liver transplantations with pediatric grafts were performed; twenty (27%) DCD and 54 (73%) DBD. The median donor warm ischemia time (DWIT) was 24 min (range 15-43 min). Patient survival rate at 10 years was 78% for recipients of DCD grafts and 89% for DBD grafts (p = 0.32). Graft survival rate at 10 years was 65% in recipients of DCD versus 76% in DBD grafts (p = 0.20). If donor livers in this study would have been rejected for transplantation when the DWIT >= 30 min (n = 4), the 10-year graft survival rate would have been 81% after DCD transplantation. The rate of non-anastomotic biliary strictures was 5% in DCD and 4% in DBD grafts (p = 1.00). Other complication rates were also similar between both groups.ConclusionsTransplantation of livers from pediatric DCD donors results in good long-term outcome especially when the DWIT is kept",

keywords = "SINGLE-CENTER EXPERIENCE, HEART-BEATING DONORS, CARDIAC DEATH, BILIARY STRICTURES, ORGAN DONATION, CHILDREN, COMPLICATIONS, INCREASE, FAILURE, INJURY",

author = "{van Rijn}, Rianne and Hoogland, {Pieter E. R.} and Frank Lehner and {van Heurn}, {Ernest L. W.} and Porte, {Robert J.}",

year = "2017",

month = apr,

day = "20",

doi = "10.1371/journal.pone.0175097",

language = "English",

volume = "12",

journal = "PLOS ONE",

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TY - JOUR

T1 - Long-term results after transplantation of pediatric liver grafts from donation after circulatory death donors

AU - van Rijn, Rianne

AU - Hoogland, Pieter E. R.

AU - Lehner, Frank

AU - van Heurn, Ernest L. W.

AU - Porte, Robert J.

PY - 2017/4/20

Y1 - 2017/4/20

N2 - BackgroundLiver grafts from donation after circulatory death (DCD) donors are increasingly accepted as an extension of the organ pool for transplantation. There is little data on the outcome of liver transplantation with DCD grafts from a pediatric donor. The objective of this study was to assess the outcome of liver transplantation with pediatric DCD grafts and to compare this with the outcome after transplantation of livers from pediatric donation after brain death (DBD) donors.MethodAll transplantations performed with a liver from a pediatric donor (ResultsIn total, 74 liver transplantations with pediatric grafts were performed; twenty (27%) DCD and 54 (73%) DBD. The median donor warm ischemia time (DWIT) was 24 min (range 15-43 min). Patient survival rate at 10 years was 78% for recipients of DCD grafts and 89% for DBD grafts (p = 0.32). Graft survival rate at 10 years was 65% in recipients of DCD versus 76% in DBD grafts (p = 0.20). If donor livers in this study would have been rejected for transplantation when the DWIT >= 30 min (n = 4), the 10-year graft survival rate would have been 81% after DCD transplantation. The rate of non-anastomotic biliary strictures was 5% in DCD and 4% in DBD grafts (p = 1.00). Other complication rates were also similar between both groups.ConclusionsTransplantation of livers from pediatric DCD donors results in good long-term outcome especially when the DWIT is kept

AB - BackgroundLiver grafts from donation after circulatory death (DCD) donors are increasingly accepted as an extension of the organ pool for transplantation. There is little data on the outcome of liver transplantation with DCD grafts from a pediatric donor. The objective of this study was to assess the outcome of liver transplantation with pediatric DCD grafts and to compare this with the outcome after transplantation of livers from pediatric donation after brain death (DBD) donors.MethodAll transplantations performed with a liver from a pediatric donor (ResultsIn total, 74 liver transplantations with pediatric grafts were performed; twenty (27%) DCD and 54 (73%) DBD. The median donor warm ischemia time (DWIT) was 24 min (range 15-43 min). Patient survival rate at 10 years was 78% for recipients of DCD grafts and 89% for DBD grafts (p = 0.32). Graft survival rate at 10 years was 65% in recipients of DCD versus 76% in DBD grafts (p = 0.20). If donor livers in this study would have been rejected for transplantation when the DWIT >= 30 min (n = 4), the 10-year graft survival rate would have been 81% after DCD transplantation. The rate of non-anastomotic biliary strictures was 5% in DCD and 4% in DBD grafts (p = 1.00). Other complication rates were also similar between both groups.ConclusionsTransplantation of livers from pediatric DCD donors results in good long-term outcome especially when the DWIT is kept

KW - SINGLE-CENTER EXPERIENCE

KW - HEART-BEATING DONORS

KW - CARDIAC DEATH

KW - BILIARY STRICTURES

KW - ORGAN DONATION

KW - CHILDREN

KW - COMPLICATIONS

KW - INCREASE

KW - FAILURE

KW - INJURY

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DO - 10.1371/journal.pone.0175097

M3 - Article

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SN - 1932-6203

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JO - PLOS ONE

JF - PLOS ONE

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ER -