Liver transplantation with grafts obtained after cardiac death-current advances in mastering the challenge  

作　　者：Fateh Bazerbachi Nazia Selzner John B Seal Markus Selzner 

机构地区：[1]Department of Medicine, University of Minnesota [2]Department of Medicine, University of Toronto,Multiorgan Transplant Program, Toronto General Hospital [3]Department of Surgery, University of Toronto, Multiorgan Transplant Program, Toronto General Hospital

出　　处：《World Journal of Translational Medicine》2014年第2期58-68,共11页世界转化医学杂志

摘　　要：The scarcity of donor livers has increased the interest in donation after cardiac death(DCD) as an additional pool to expand the availability of organs. However, the initial results of liver transplantation with DCD grafts have been suboptimal due to an increased rate of complications, as well as decreased graft survival. These challenges have led to many developments in DCD donation outcome, as well as basic and translational research. In this article we review the unique characteristics of DCD donors, nuances of DCD organ procurement, the effect of prolonged warm and cold ischemia times, and discuss major studies that compared DCD to donation after brain death liver transplantation, in terms of outcomes and complications. We also review the different methods of donor treatment that has been applied to ameliorate DCD organ outcome, and we discuss the role of machine perfusion techniques in organ reconditioning. We discuss the two major perfusionmodels, namely, hypothermic machine perfusion and normothermic machine perfusion; we compare both methods, and delineate their major differences.The scarcity of donor livers has increased the interest in donation after cardiac death(DCD) as an additional pool to expand the availability of organs. However, the initial results of liver transplantation with DCD grafts have been suboptimal due to an increased rate of complications, as well as decreased graft survival. These challenges have led to many developments in DCD donation outcome, as well as basic and translational research. In this article we review the unique characteristics of DCD donors, nuances of DCD organ procurement, the effect of prolonged warm and cold ischemia times, and discuss major studies that compared DCD to donation after brain death liver transplantation, in terms of outcomes and complications. We also review the different methods of donor treatment that has been applied to ameliorate DCD organ outcome, and we discuss the role of machine perfusion techniques in organ reconditioning. We discuss the two major perfusionmodels, namely, hypothermic machine perfusion and normothermic machine perfusion; we compare both methods, and delineate their major differences.

关 键 词：Transplant hepatology LIVER transplantation Organ DONATION Extended criteria donors DONATION AFTER cardiac death EX-VIVO LIVER PERFUSION Normothermic MACHINE PERFUSION Hypothermic MACHINE PERFUSION 

分 类 号：R[医药卫生]