Poster 19. Clinical outcomes of DCD type V liver transplantation: donation after euthanasia

Thursday 14 march 2019

12:39 - 12:42h

Categories: Klinisch, Postersessie

Parallel session: Postersessies 4 - Clinical

M. van Reeven1, O.B. van Leeuwen2, D. van der Helm3, S. Darwish Murad4, J. Blokzijl5, B. van Hoek3, I. Alwayn6, R.J. Porte2, J.N.M. IJzermans1, W.G. Polak1

1Dept. of Surgery, Division of Hepatopancreatobiliary and Transplant Surgery, Erasmus University Medical Center, Rotterdam2Dept. of Surgery, Section of Hepatobiliary Surgery & Liver Transplantation, University Medical Center Groningen, Groningen3Dept. of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden.4Dept. of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam. 5Dept. of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen. 6Dept. of Surgery, division of Hepatopancreatobiliary and Transplant Surgery, Leiden University Medical Center, Leiden, The Netherlands.

Background: Due to the growing shortage of donor organs, physicians and surgeons are forced to accept livers from donation after circulatory death (DCD) donors. One special group of DCD organs are those obtained after euthanasia (DCD type V according to the modified Maastricht classification). To create more awareness on the possibility of organ donation after euthanasia, it is of great importance to evaluate the results of transplantation with this type of graft. The aim of this study was to evaluate the outcome of DCD type V liver transplantation (LT) in the Netherlands.

Methods: All DCD type V LT performed in the Netherlands until 2018 were included in this retrospective study except for the cases in which the graft has been preserved with machine perfusion. Continuous data are expressed as median (inter quartile range), categorical data as number (percentage).

Results: Until 2018, 22 DCD type V LT have been performed in the Netherlands. Five cases in which the liver was preserved by machine perfusion were excluded. Median age of donor and recipient was 53 years (45-57) and 53 years (45-63), respectively. A neurodegenerative disease was the most common underlying disease in donors requesting euthanasia, followed by multiple sclerosis. Median time between administration of the euthanaticum and cold perfusion in the donor was 24 minutes (21-30). Peak AST and ALT levels in the recipients were 867 U/L (730-2701) and 757 U/L (608-2739) respectively. After a median follow up of 2.5 years all recipients are still alive. Three patients (17.6%) required a retransplantation, due to PNF (n=1) or post-transplant cholangiopathy (n=2), all within the first year after the prior LT.

Conclusions: Liver transplantations with grafts from donors who underwent euthanasia yield satisfying results during the relatively short follow up period that is currently available. Comparison of these results with DCD type III LT and donation after brain death (DBD) LT