Author(s): Fondevila C, Hessheimer AJ, Flores E, Ruiz A, Mestres N,
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Abstract Maastricht type 2 donation after cardiac death (DCD) donors suffer sudden and unexpected cardiac arrest, typically outside the hospital; they have significant potential to expand the donor pool. Herein, we analyze the results of transplanted livers and all potential donors treated under our type 2 DCD protocol. Cardiac arrest was witnessed; potential donors arrived at the hospital after attempts at resuscitation had failed. Death was declared based on the absence of cardiorespiratory activity during a 5-min no-touch period. Femoral vessels were cannulated to establish normothermic extracorporeal membrane oxygenation, which was maintained until organ recovery. From April 2002 to December 2010, there were 400 potential donors; 34 liver transplants were performed (9\%). Among recipients, median age, model for end-stage liver disease and cold and reperfusion warm ischemic times were 55 years (49-60), 19 (14-21) and 380 (325-430) and 30 min (26-35), respectively. Overall, 236 (59\%) and 130 (32\%) livers were turned down due to absolute and relative contraindications to donate, respectively. One-year recipient and graft survivals were 82\% and 70\%, respectively (median follow-up 24 months). The applicability of type 2 DCD liver transplant was <10\%; however, with better preservation technology and expanded transplant criteria, we may be able to improve this figure significantly. ©Copyright 2011 The American Society of Transplantation and the American Society of Transplant Surgeons.
This article was published in Am J Transplant
and referenced in Internal Medicine: Open Access