Clinical efficacy of liver transplantation using aged liver grafts from donation after citizen′s death

Abstract

Objective : To explore the clinical efficacy of liver transplantation using aged liver grafts from donation after citizen′s death (DCD). Methods The retrospective case-control study was adopted. The clinico-pathological data of 146 patients who underwent liver transplatation using liver grafts from DCD at the Tongji Hospital of Huazhong University of Science and Technology from January 2011 to December 2015 were collected. Of 146 patients, forty-six recipients who received liver grafts from donors≥60 years were allocated into the donor age≥60 years group and 100 who received liver grafts from donor age<60 years were allocated into the donor age<60 years group. Observed indicators included: (1) the incidence of primary liver graft nonfunction (PNF) and initial poor function (IPF) of transplanted liver, (2) liver function recovery in the first postoperative month, (3) the postoperative complications, including reoperation because of bleeding, acute rejection, thrombosis of hepatic artery, thrombosis of portal vein, biliary complications, neurological complications, bacterial infection, cytomegalovirus infection and adverse reaction of calcineurin inhibitors, (4) postoperative survival rate in liver transplant recipients. The regular follow-up using outpatient examination was performed to detect indexes of laboratory examination and postoperative complications and survival of patients till January 2016. Measurement data with normal distribution were represented as ±s and comparison between groups was evaluated with the independent t test. Measurement data with skewed distribution were represented as M(Qn) and analyzed by Mann-Whitney test. Count data were analyzed using the chi-square test. Results (1) The incidences of PNF and IPF of transplanted liver: two patients in the donor age≥60 years group and 1 patient in the donor age 0.05). Eight patients in the donor age≥60 years group and 6 patients in the donor age 0.05). Nine patients had adverse reaction of calcineurin inhibitors in the donor age≥60 years group and 6 patients in the donor age 0.05). Conclusion Using liver grafts from donor age≥60 years after strict selection can achieve good therapeutic effects in liver transplantation. Key words: Liver diseases; Aged liver graft; Donation after citizen′s death; Liver transplantation