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Your search keyword '"donor after circulatory death"' showing total 4 results
Start Over Descriptor "donor after circulatory death" Topic liver transplantation
4 results on '"donor after circulatory death"'

1. Single Center Experience with Incidence, Impact and Predictors of Biliary Complications in Donation After Circulatory Death Liver Transplantation.

Author

Bushara O, Alhalel J, Sanders J, Azad H, Cerri T, Zafer S, Guo K, Zhao L, Daud A, Borja-Cacho D, and Caicedo-Ramirez JC

Subjects
Death, Graft Survival, Humans, Incidence, Postoperative Complications epidemiology, Postoperative Complications etiology, Retrospective Studies, Tissue Donors, Liver Transplantation adverse effects, Tissue and Organ Procurement
Abstract

Introduction: Utilizing allografts from donors after cardiac death (DCD) has improved organ availability, and DCD livers comprise a growing proportion of transplantations. However, it has been suggested that DCD transplantations have worse outcomes. Research Questions: We aimed to characterize outcomes in a large cohort of DCD transplantations, identify trends in outcomes over time, and identify factors associated with the development of biliary complications. Design: We conducted an observational retrospective cohort study of patients receiving DCD liver allografts within a large academic teaching hospital with a high transplantation volume. Consecutive patients who underwent Type III DCD liver transplantation from 2006-2016 were included in our cohort. Re-transplantations and multi-organ transplant recipients were excluded. Results: Ninety-six type III DCD transplantations occurred between 2006-2016. We report a 1one-year patient survival of 90.6% (87) and a 5five-year patient survival of 69.8% (67). Twenty-nine (30.2%) patients experienced any biliary complication in the first year following discharge, with 17 (17.7%) experiencing ischemic cholangiopathy. Five-year patient (P = 0.04) and graft (P = 0.005) survival improved over time. Post-operative biliary complications experienced during index admission and prior to discharge were found to be associated with the development of biliary complications (P = 0.005) and ischemic cholangiopathy (P = 0.01) following discharge. Conclusion: Our data suggested that outcomes using DCD allografts have improved, however biliary complications remain a significant issue in DCD transplantation. Patients who experienced post-operative biliary complications during index admission may require more frequent screening to allow the initiation of earlier treatment for biliary complications.

Published
2022
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2. Patient with liver dysfunction while maintained on veno-venous extracorporeal membrane oxygenation should not be overlooked as a potential donor.

Author

Mourad MM, Reay M, Muiesan P, Mirza DF, and Perera MT

Subjects
Adult, Disease Progression, Follow-Up Studies, Graft Survival, Heart Arrest therapy, Humans, Liver Diseases surgery, Living Donors, Middle Aged, Pulmonary Fibrosis diagnosis, Pulmonary Fibrosis surgery, Respiratory Insufficiency diagnosis, Risk Assessment, Transplant Recipients, Treatment Outcome, Extracorporeal Membrane Oxygenation methods, Liver Diseases diagnosis, Liver Transplantation methods, Respiratory Insufficiency surgery, Tissue and Organ Procurement
Abstract

This report describes transplantation of liver allograft from a circulatory death donor who was supported by veno-venous extracorporeal membrane oxygenation (ECMO) for 14 days and presented with severely altered liver functions. Successful liver transplant was done in a patient with hepatocellular carcinoma (HCC) in the background of primary sclerosing cholangitis. There was immediate graft function and uneventful recovery with stable graft function at 1-year follow-up. This case illustrates the ability of veno-venous ECMO to resuscitate organs in the presence of severe dysfunction, and perhaps, lessons from this case may be incorporated to optimize the condition of organs rescued from these marginal donors and exemplify the use of ECMO in normothermic regional perfusion in donors after circulatory death., (© 2014 Steunstichting ESOT.)

Published
2014
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3. Machine Perfusions in Liver Transplantation: The Evidence‐Based Position Paper of the Italian Society of Organ and Tissue Transplantation

Author

Paolo Muiesan, Massimo Rossi, Damiano Patrono, F. Melandro, Daniele Pezzati, Markus Selzner, Alberto Zanella, Andrea Lauterio, Riccardo De Carlis, Cristiano Quintini, Stefano Baroni, Domenico Bassi, Davide Ghinolfi, Paolo Magistri, Fabio Ferla, Luca Toti, Marinella Zanierato, Matteo Ravaioli, Quirino Lai, Chiara Lazzeri, Wayel Jassem, Patrizia Burra, Daniele Dondossola, Duilio Pagano, Philippe Dutkowski, Umberto Cillo, Erion Rreka, Salvatore Petta, University of Zurich, Ghinolfi, Davide, Ghinolfi, D, Lai, Q, Dondossola, D, De Carlis, R, Zanierato, M, Patrono, D, Baroni, S, Bassi, D, Ferla, F, Lauterio, A, Lazzeri, C, Magistri, P, Melandro, F, Pagano, D, Pezzati, D, Ravaioli, M, Rreka, E, Toti, L, Zanella, A, Burra, P, Petta, S, Rossi, M, Dutkowski, P, Jassem, W, Muiesan, P, Quintini, C, Selzner, M, Cillo, U, Ghinolfi D., Lai Q., Dondossola D., De Carlis R., Zanierato M., Patrono D., Baroni S., Bassi D., Ferla F., Lauterio A., Lazzeri C., Magistri P., Melandro F., Pagano D., Pezzati D., Ravaioli M., Rreka E., Toti L., Zanella A., Burra P., Petta S., Rossi M., Dutkowski P., Jassem W., Muiesan P., Quintini C., Selzner M., and Cillo U.

Subjects
medicine.medical_specialty, Evidence-based practice, 2747 Transplantation, GRADE, donor after circulatory death, donor brain death, hypothermic machine, liver transplant, machine perfusion, normothermic machine, normothermic regional perfusion, position paper, medicine.medical_treatment, Delphi method, MEDLINE, 610 Medicine & health, liver, perfusion machine, 030230 surgery, Liver transplantation, liver, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Medical physics, 10217 Clinic for Visceral and Transplantation Surgery, HumansItaly, Transplantation, Machine perfusion, Hepatology, business.industry, Organ Preservation, perfusion machine, Institutional review board, Liver Transplantation, 2746 Surgery, Perfusion, Italy, Position paper, 2721 Hepatology, 030211 gastroenterology & hepatology, Surgery, business, Human
Abstract

The use of machine perfusion (MP) in liver transplantation (LT) is spreading worldwide. However, its efficacy has not been demonstrated, and its proper clinical use has far to go to be widely implemented. The Società Italiana Trapianti d’Organo (SITO) promoted the development of an evidence-based position paper. A 3-step approach has been adopted to develop this position paper. First, SITO appointed a chair and a cochair who then assembled a working group with specific experience of MP in LT. The Guideline Development Group framed the clinical questions into a patient, intervention, control, and outcome (PICO) format, extracted and analyzed the available literature, ranked the quality of the evidence, and prepared and graded the recommendations. Recommendations were then discussed by all the members of the SITO and were voted on via the Delphi method by an institutional review board. Finally, they were evaluated and scored by a panel of external reviewers. All available literature was analyzed, and its quality was ranked. A total of 18 recommendations regarding the use and the efficacy of ex situ hypothermic and normothermic machine perfusion and sequential normothermic regional perfusion and ex situ MP were prepared and graded according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. A critical and scientific approach is required for the safe implementation of this new technology.

Published
2020

4. Patient with liver dysfunction while maintained on veno-venous extracorporeal membrane oxygenation should not be overlooked as a potential donor

Author

M. Thamara P. R. Perera, Paolo Muiesan, Michael Reay, Darius F. Mirza, and Moustafa Mabrouk Mourad

Subjects
Adult, medicine.medical_specialty, Tissue and Organ Procurement, Pulmonary Fibrosis, medicine.medical_treatment, Liver transplantation, Risk Assessment, Primary sclerosing cholangitis, Extracorporeal Membrane Oxygenation, donor after circulatory death, extracorporeal membrane oxygenation, graft dysfunction, marginal donor, Disease Progression, Follow-Up Studies, Graft Survival, Heart Arrest, Humans, Liver Diseases, Liver Transplantation, Living Donors, Middle Aged, Respiratory Insufficiency, Transplant Recipients, Treatment Outcome, Pulmonary fibrosis, medicine, Extracorporeal membrane oxygenation, Transplantation, business.industry, medicine.disease, Surgery, surgical procedures, operative, TheoryofComputation_LOGICSANDMEANINGSOFPROGRAMS, Hepatocellular carcinoma, Potential donor, Liver dysfunction, business
Abstract

This report describes transplantation of liver allograft from a circulatory death donor who was supported by veno-venous extracorporeal membrane oxygenation (ECMO) for 14 days and presented with severely altered liver functions. Successful liver transplant was done in a patient with hepatocellular carcinoma (HCC) in the background of primary sclerosing cholangitis. There was immediate graft function and uneventful recovery with stable graft function at 1-year follow-up. This case illustrates the ability of veno-venous ECMO to resuscitate organs in the presence of severe dysfunction, and perhaps, lessons from this case may be incorporated to optimize the condition of organs rescued from these marginal donors and exemplify the use of ECMO in normothermic regional perfusion in donors after circulatory death.

Published
2014

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