Incidence and risk factors of primary non‐function after liver transplantation using grafts from uncontrolled donors after circulatory death. Issue 1 (20th November 2020)

• Record Type: Journal Article
• Authors: Justo, Iago; Nutu, Anisa; García‐Conde, María; Marcacuzco, Alberto; Manrique, Alejandro; Calvo, Jorge; García‐Sesma, Álvaro; Caso, Óscar; Martín‐Arriscado, Carmen; Andrés, Amado; Paz, Estela; Jiménez‐Romero, Carlos
• Is Part Of: Clinical transplantation. Volume 35:Issue 1(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-11-20
• Subjects: expanded donor pool -- extended criteria donors -- liver transplantation -- post‐transplant complications -- primary non‐function -- uncontrolled donation after circulatory death; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.14134
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Background: Graft primary non‐function (PNF) is the most severe complication after orthotopic liver transplantation (OLT) and is frequently associated with livers from uncontrolled circulatory death (uDCD). Methods: We reviewed retrospectively the incidence, risk factors, and outcome of patients showing PNF after receiving uDCD liver grafts. The series comprises 75 OLT performed during 11 years. Results: The incidence of PNF using uDCD livers was 8%. We compared patients who developed PNF ( n = 6) vs. patients without PNF ( n = 69). Mean pump flow of donors during normothermic regional perfusion (NRP) was significantly lower in PNF ( p = .032). Day 1 post‐OLT levels of transaminases and the incidence of renal complications and postoperative mortality were also significantly higher in the PNF group, but 5‐year patient survival was similar in both groups (66.7% in PNF and 68.5% in non‐PNF). All PNF patients underwent re‐OLT, and 2 died. PNF incidence has decreased in the last 5‐years. Binary logistic regression analysis confirmed final ALT value >4 times the normal value as risk factor for PNF, and median donor pump flow >3700 ml/min as protective effect. Conclusions: Adequate donor pump flow during NRP was a protective.