Comorbidities and Age in Brain-Dead Donors and Liver Transplantation: A 15-Year Retrospective Investigation

Lazzeri, Chiara; Bonizzoli, Manuela; Ghinolfi, Davide; Simone, Paolo De; Pezzati, Daniele; Rreka, Erion; Bombardi, Marco; Migliaccio, Maria Luisa; Peris, Adriano

doi:10.6002/ect.2019.0168

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…In this study, we showed that donor hepatectomy time was not associated with graft or patient survival, need for retransplantation, or length of ICU or hospital stay. Probably, other donor, recipient, and surgical procedure characteristics, such as previous comorbidities[ 21 ], age[ 22 ], underlying disease[ 19 ], and bleeding volume[ 23 , 24 ], are better determinants of these outcomes than hepatectomy time itself. For instance, liver grafts recovered from donors after cardiac death undergo distinct ischemic insults during procurement, exhibiting differences in nature and severity of injury.…”

Section: Discussionmentioning

confidence: 99%

Association of donor hepatectomy time with liver transplantation outcomes: A multicenter retrospective study

Custodio,

Massutti,

Caramori

et al. 2024

World J Transplant

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BACKGROUND Prolonged donor hepatectomy time may be implicated in early and late complications of liver transplantation. AIM To evaluate the impact of donor hepatectomy time on outcomes of liver transplant recipients, mainly early allograft dysfunction. METHODS This multicenter retrospective study included brain-dead donors and adult liver graft recipients. Donor-recipient matching was obtained through a crossover list. Clinical and laboratory data were recorded for both donors and recipients. Donor hepatectomy, cold ischemia, and warm ischemia times were recorded. Primary outcome was early allograft dysfunction. Secondary outcomes included need for retransplantation, length of intensive care unit and hospital stay, and patient and graft survival at 12 months. RESULTS From January 2019 to December 2021, a total of 243 patients underwent a liver transplant from a brain-dead donor. Of these, 57 (25%) developed early allograft dysfunction. The median donor hepatectomy time was 29 (23–40) min. Patients with early allograft dysfunction had a median hepatectomy time of 25 (22–38) min, whereas those without it had a median time of 30 (24–40) min (P = 0.126). CONCLUSION Donor hepatectomy time was not associated with early allograft dysfunction, graft survival, or patient survival following liver transplantation.

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Section: Discussionmentioning

confidence: 99%

Association of donor hepatectomy time with liver transplantation outcomes: A multicenter retrospective study

Custodio,

Massutti,

Caramori

et al. 2024

World J Transplant

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“…This led to extended donor age and donor-related comorbidities, such as diabetes, hypertension, or liver steatosis, predisposing to PTMD as well as older liver donor graft after circulatory death. 144,164,[185][186][187]…”

Section: Liver Donor-related Factorsmentioning

confidence: 99%

Management of Diabetes in Candidates for Liver Transplantation and in Transplant Recipients

et al. 2021

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Diabetes is common in patients waitlisted for liver transplantation because of end-stage liver disease or hepatocellular cancer as well as in posttransplant phase (posttransplantation diabetes mellitus). In both conditions, the presence of diabetes severely affects disease burden and long-term clinical outcomes; careful monitoring and appropriate treatment are pivotal to reduce cardiovascular events and graft and recipients' death. We thoroughly reviewed the epidemiology of diabetes in the transplant setting and the different therapeutic options, from lifestyle intervention to antidiabetic drug use-including the most recent drug classes available-and to the inclusion of bariatric surgery in the treatment cascade. In waitlisted patients, the old paradigm that insulin should be the treatment of choice in the presence of severe liver dysfunction is no longer valid; novel antidiabetic agents may provide adequate glucose control without the risk of hypoglycemia, also offering cardiovascular protection. The same evidence applies to the posttransplant phase, where oral or injectable noninsulin agents should be considered to treat patients to target, limiting the impact of disease on daily living, without interaction with immunosuppressive regimens. The increasing prevalence of liver disease of metabolic origin (nonalcoholic fatty liver) among liver transplant candidates, also having a higher risk of noncirrhotic hepatocellular cancer, is likely to accelerate the acceptance of new drugs and invasive procedures, as suggested by international guidelines. Intensive lifestyle intervention programs remain however mandatory, both before and after transplantation. Achievement of adequate control is mandatory to increase candidacy, to prevent delisting, and to improve long-term outcomes.

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2024

Exp Clin Transplant

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Comorbidities and Age in Brain-Dead Donors and Liver Transplantation: A 15-Year Retrospective Investigation

Cited by 3 publications

References 21 publications

Association of donor hepatectomy time with liver transplantation outcomes: A multicenter retrospective study

Association of donor hepatectomy time with liver transplantation outcomes: A multicenter retrospective study

Management of Diabetes in Candidates for Liver Transplantation and in Transplant Recipients

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