Outcomes in DCD Liver Transplantation
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Within the last decade, liver transplantation from DCD donors has gained interest and outcomes have improved, mainly due to an increased awareness of the overall risk and subsequent selection policy. Although most countries have steadily pushed their donor risk factor boundaries, the overall utilization rate of DCD livers remains suboptimal. The repeat occurrences of DCD-specific complications, difficult to reduce further, are highlighted as one reason behind such advancement standstill, despite the continuous technical, medical, and anesthesiologic innovation.
This chapter highlights most outcome measures after DCD liver transplantation including graft and patient survival with a specific focus on biliary, vascular, and renal complications. Overall graft and donor risk is discussed in context of liver reperfusion injury and graft function with the development of specific complications. Finally, suggestions on how to assess and report outcomes in a more standardized and transparent way are provided to further improve our results in the future.
KeywordsOutcome Graft survival Risk factors Ischemic cholangiopathy Retransplantation
Area under the receiver operating characteristic curve statistic
- BAR score
Balance of risk score
Body mass index
Cold ischemia time
Direct-acting antiviral medications
Donation after brain death
Donation after circulatory death
Donor Risk Index
Early allograft dysfunction
Extracorporeal membrane oxygenation
Endoscopic retrograde cholangiopancreatography
functional donor warm ischemia time
Hepatic artery stenosis
Hepatic artery thrombosis
Hepatitis B virus
Hepatitis C virus
Hypothermic machine perfusion
Hypothermic oxygenated perfusion
Intensive care unit
King’s College Hospital
Model of End Liver Disease
National Health Service
National Health Service Blood and Transplant
Normothermic machine perfusion
Normothermic regional perfusion
Orthotopic liver transplantation
Percutaneous transhepatic cholangiography
Reactive oxygen species
University Hospitals Birmingham
- UK-DCD-Risk Score
United Kingdom Donation After Circulatory Death Risk Score
United Kingdom Model of End-Stage Liver Disease
United Network of Organ Sharing
United States of America
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