Good post-transplant outcomes using liver donors after circulatory death when applying strict selection criteria: a propensity-score matched-cohort study

Varga, Molly; Valle, Pablo del Pozo-del; Béjar-Serrano, Sergio; López‐Andújar, Rafael; Berenguer, Marina; Prieto, Martín; Montalvá, Eva; Aguilera, Victoria

doi:10.1016/j.aohep.2022.100724

Cited by 5 publications

(2 citation statements)

References 40 publications

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“…Hypothermic machine perfusion helps recondition the graft by decreasing the degree of ischemia reperfusion injury [64], with some reports even implying this might lower the risk of post-transplant cancer recurrence in the long term [65]. In addition, the emerging use of normothermic regional perfusion can certainly improve the utilization of organs from donation after cardiac death, for which patients with CRLM and good hepatic function would be ideal recipients [66,67].…”

Section: Open Issues In Ethical Considerationsmentioning

confidence: 99%

Liver Transplantation for Hepatic Metastases from Colorectal Cancer: Current Knowledge and Open Issues

Maspero

Sposito

Virdis

et al. 2023

Cancers

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More than 40% of patients with colorectal cancer present liver metastases (CRLM) during the course of their disease and up to 50% present with unresectable disease. Without surgical interventions, survival for patients treated with systemic therapies alone is dismal. In the past, liver transplantation (LT) for patients with unresectable CRLM failed to show any survival benefit due to poor selection, ineffective chemotherapeutic regimens, unbalanced immunosuppression and high perioperative mortality. Since then and for many years LT for CRLM was abandoned. The turning point occurred in 2013, when the results from the Secondary Cancer (SECA I) pilot study performed at Oslo University were published reporting a 60% 5-year overall survival after LT in patients with unresectable CRLM. These results effectively reignited the interest in LT as a potential therapy for CRLM, and several trials are undergoing. The aims of this article are to give a comprehensive overview of the available evidence on LT for CRLM, discuss the open issues in this rapidly evolving field, and highlight possible ways to address the future of this fascinating therapeutic alternative for selected patients with CRLM.

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Section: Open Issues In Ethical Considerationsmentioning

confidence: 99%

Liver Transplantation for Hepatic Metastases from Colorectal Cancer: Current Knowledge and Open Issues

Maspero

Sposito

Virdis

et al. 2023

Cancers

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“…DCD donors are a valuable source of grafts, even if concerns have been raised about potentially impaired outcomes related to prolonged warm ischemia time (WIT). Nevertheless, several recent studies have described acceptable results after transplantation involving those donors [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Beyond the Concepts of Elder and Marginal in DCD Liver Transplantation: A Prospective Observational Matched-Cohort Study in the Italian Clinical Setting

Fallani,

Stocco,

Siniscalchi

et al. 2023

Transpl Int

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Donation after circulatory determination of death (DCD) is a valuable strategy to increase the availability of grafts for liver transplantation (LT). As the average age of populations rises, the donor pool is likely to be affected by a potential increase in DCD donor age in the near future. We conducted a prospective cohort study to evaluate post-transplantation outcomes in recipients of grafts from elderly DCD donors compared with younger DCD donors, and elderly donors after brainstem determination of death (DBD). From August 2020 to May 2022, consecutive recipients of deceased donor liver-only transplants were enrolled in the study. DCD recipients were propensity score matched 1:3 to DBD recipients. One-hundred fifty-seven patients were included, 26 of whom (16.6%) were transplanted with a DCD liver graft. After propensity score matching and stratification, three groups were obtained: 15 recipients of DCD donors ≥75 years, 11 recipients of DCD donors <75 years, and 28 recipients of DBD donors ≥75 years. Short-term outcomes, as well as 12 months graft survival rates (93.3%, 100%, and 89.3% respectively), were comparable among the groups. LT involving grafts retrieved from very elderly DCD donors was feasible and safe in an experienced high-volume center, with outcomes comparable to LTs from younger DCD donors and age-matched DBD donors.

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Predictors of poor postoperative outcomes in liver transplant patients

Buldukoglu

2024

Annals of Hepatology

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Good post-transplant outcomes using liver donors after circulatory death when applying strict selection criteria: a propensity-score matched-cohort study

Cited by 5 publications

References 40 publications

Liver Transplantation for Hepatic Metastases from Colorectal Cancer: Current Knowledge and Open Issues

Liver Transplantation for Hepatic Metastases from Colorectal Cancer: Current Knowledge and Open Issues

Beyond the Concepts of Elder and Marginal in DCD Liver Transplantation: A Prospective Observational Matched-Cohort Study in the Italian Clinical Setting

Predictors of poor postoperative outcomes in liver transplant patients

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