Cargando…
Comparison of Biliary Complications Rates After Brain Death, Donation After Circulatory Death, and Living-Donor Liver Transplantation: A Single-Center Cohort Study
Donation-after-circulatory-death (DCD), donation-after-brain-death (DBD), and living-donation (LD) are the three possible options for liver transplantation (LT), each with unique benefits and complication rates. We aimed to compare DCD-, DBD-, and LD-LT-specific graft survival and biliary complicati...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9780276/ https://www.ncbi.nlm.nih.gov/pubmed/36568142 http://dx.doi.org/10.3389/ti.2022.10855 |
_version_ | 1784856801660895232 |
---|---|
author | Meier, Raphael Pascal Henri Kelly, Yvonne Braun, Hillary Maluf, Daniel Freise, Chris Ascher, Nancy Roberts, John Roll, Garrett |
author_facet | Meier, Raphael Pascal Henri Kelly, Yvonne Braun, Hillary Maluf, Daniel Freise, Chris Ascher, Nancy Roberts, John Roll, Garrett |
author_sort | Meier, Raphael Pascal Henri |
collection | PubMed |
description | Donation-after-circulatory-death (DCD), donation-after-brain-death (DBD), and living-donation (LD) are the three possible options for liver transplantation (LT), each with unique benefits and complication rates. We aimed to compare DCD-, DBD-, and LD-LT-specific graft survival and biliary complications (BC). We collected data on 138 DCD-, 3,027 DBD- and 318 LD-LTs adult recipients from a single center and analyzed patient/graft survival. BC (leak and anastomotic/non-anastomotic stricture (AS/NAS)) were analyzed in a subset of 414 patients. One-/five-year graft survival were 88.6%/70.0% for DCD-LT, 92.6%/79.9% for DBD-LT, and, 91.7%/82.9% for LD-LT. DCD-LTs had a 1.7-/1.3-fold adjusted risk of losing their graft compared to DBD-LT and LD-LT, respectively (p < 0.010/0.403). Bile leaks were present in 10.1% (DCD-LTs), 7.2% (DBD-LTs), and 36.2% (LD-LTs) (ORs, DBD/LD vs. DCD: 0.7/4.2, p = 0.402/<0.001). AS developed in 28.3% DCD-LTs, 18.1% DBD-LTs, and 43.5% LD-LTs (ORs, DBD/LD vs. DCD: 0.5/1.8, p = 0.018/0.006). NAS was present in 15.2% DCD-LTs, 1.4% DBDs-LT, and 4.3% LD-LTs (ORs, DBD/LD vs. DCD: 0.1/0.3, p = 0.001/0.005). LTs w/o BC had better liver graft survival compared to any other groups with BC. DCD-LT and LD-LT had excellent graft survival despite significantly higher BC rates compared to DBD-LT. DCD-LT represents a valid alternative whose importance should increase further with machine/perfusion systems. |
format | Online Article Text |
id | pubmed-9780276 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97802762022-12-24 Comparison of Biliary Complications Rates After Brain Death, Donation After Circulatory Death, and Living-Donor Liver Transplantation: A Single-Center Cohort Study Meier, Raphael Pascal Henri Kelly, Yvonne Braun, Hillary Maluf, Daniel Freise, Chris Ascher, Nancy Roberts, John Roll, Garrett Transpl Int Health Archive Donation-after-circulatory-death (DCD), donation-after-brain-death (DBD), and living-donation (LD) are the three possible options for liver transplantation (LT), each with unique benefits and complication rates. We aimed to compare DCD-, DBD-, and LD-LT-specific graft survival and biliary complications (BC). We collected data on 138 DCD-, 3,027 DBD- and 318 LD-LTs adult recipients from a single center and analyzed patient/graft survival. BC (leak and anastomotic/non-anastomotic stricture (AS/NAS)) were analyzed in a subset of 414 patients. One-/five-year graft survival were 88.6%/70.0% for DCD-LT, 92.6%/79.9% for DBD-LT, and, 91.7%/82.9% for LD-LT. DCD-LTs had a 1.7-/1.3-fold adjusted risk of losing their graft compared to DBD-LT and LD-LT, respectively (p < 0.010/0.403). Bile leaks were present in 10.1% (DCD-LTs), 7.2% (DBD-LTs), and 36.2% (LD-LTs) (ORs, DBD/LD vs. DCD: 0.7/4.2, p = 0.402/<0.001). AS developed in 28.3% DCD-LTs, 18.1% DBD-LTs, and 43.5% LD-LTs (ORs, DBD/LD vs. DCD: 0.5/1.8, p = 0.018/0.006). NAS was present in 15.2% DCD-LTs, 1.4% DBDs-LT, and 4.3% LD-LTs (ORs, DBD/LD vs. DCD: 0.1/0.3, p = 0.001/0.005). LTs w/o BC had better liver graft survival compared to any other groups with BC. DCD-LT and LD-LT had excellent graft survival despite significantly higher BC rates compared to DBD-LT. DCD-LT represents a valid alternative whose importance should increase further with machine/perfusion systems. Frontiers Media S.A. 2022-12-09 /pmc/articles/PMC9780276/ /pubmed/36568142 http://dx.doi.org/10.3389/ti.2022.10855 Text en Copyright © 2022 Meier, Kelly, Braun, Maluf, Freise, Ascher, Roberts and Roll. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Health Archive Meier, Raphael Pascal Henri Kelly, Yvonne Braun, Hillary Maluf, Daniel Freise, Chris Ascher, Nancy Roberts, John Roll, Garrett Comparison of Biliary Complications Rates After Brain Death, Donation After Circulatory Death, and Living-Donor Liver Transplantation: A Single-Center Cohort Study |
title | Comparison of Biliary Complications Rates After Brain Death, Donation After Circulatory Death, and Living-Donor Liver Transplantation: A Single-Center Cohort Study |
title_full | Comparison of Biliary Complications Rates After Brain Death, Donation After Circulatory Death, and Living-Donor Liver Transplantation: A Single-Center Cohort Study |
title_fullStr | Comparison of Biliary Complications Rates After Brain Death, Donation After Circulatory Death, and Living-Donor Liver Transplantation: A Single-Center Cohort Study |
title_full_unstemmed | Comparison of Biliary Complications Rates After Brain Death, Donation After Circulatory Death, and Living-Donor Liver Transplantation: A Single-Center Cohort Study |
title_short | Comparison of Biliary Complications Rates After Brain Death, Donation After Circulatory Death, and Living-Donor Liver Transplantation: A Single-Center Cohort Study |
title_sort | comparison of biliary complications rates after brain death, donation after circulatory death, and living-donor liver transplantation: a single-center cohort study |
topic | Health Archive |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9780276/ https://www.ncbi.nlm.nih.gov/pubmed/36568142 http://dx.doi.org/10.3389/ti.2022.10855 |
work_keys_str_mv | AT meierraphaelpascalhenri comparisonofbiliarycomplicationsratesafterbraindeathdonationaftercirculatorydeathandlivingdonorlivertransplantationasinglecentercohortstudy AT kellyyvonne comparisonofbiliarycomplicationsratesafterbraindeathdonationaftercirculatorydeathandlivingdonorlivertransplantationasinglecentercohortstudy AT braunhillary comparisonofbiliarycomplicationsratesafterbraindeathdonationaftercirculatorydeathandlivingdonorlivertransplantationasinglecentercohortstudy AT malufdaniel comparisonofbiliarycomplicationsratesafterbraindeathdonationaftercirculatorydeathandlivingdonorlivertransplantationasinglecentercohortstudy AT freisechris comparisonofbiliarycomplicationsratesafterbraindeathdonationaftercirculatorydeathandlivingdonorlivertransplantationasinglecentercohortstudy AT aschernancy comparisonofbiliarycomplicationsratesafterbraindeathdonationaftercirculatorydeathandlivingdonorlivertransplantationasinglecentercohortstudy AT robertsjohn comparisonofbiliarycomplicationsratesafterbraindeathdonationaftercirculatorydeathandlivingdonorlivertransplantationasinglecentercohortstudy AT rollgarrett comparisonofbiliarycomplicationsratesafterbraindeathdonationaftercirculatorydeathandlivingdonorlivertransplantationasinglecentercohortstudy |