Outcomes of Liver Transplantation Using Older Donors After Circulatory Death and the Super-Rapid Technique: 14 Cases

Abstract

IntroductionDonation after circulatory death (DCD) has increased in the last decade, although a slight increase in surgical complications has been reported in liver transplantation (LT). Therefore, DCD is not recommended with donors aged 60 years or more because it entails an added risk. However, donation after brain death (DBD)-LT with donors aged 70 years or more shows acceptable results. ObjectiveThe objective was to analyze the characteristics and complications of DCD-LT with donors aged 70 years or more (DCD-70). Materials and MethodsWe included 14 DCD-70-LT and compared them with a control group of 28 DBD-LT aged 70 years or more. Statistical AnalysisA descriptive analysis, Mann-Whitney U test, and Pearson chi-square or Fisher test were performed when appropriate. ResultsSignificant differences were found in aminotransferase peak at 24 hours, with an increase in the DCD-70 group (aspartate aminotransferease [AST] 1038 vs 507, P = .013; alanine aminotransferase [ALT] 750 vs 399, P = .014). The cold ischemia time was lower in DCD-70 although without significant differences (4.8 vs 6.7 hours). Biliary complications (28.6% vs 31.7%) and vascular complications (7.1% vs 7.1%) were similar. A single transplant with DCD-70 required a retransplantation due to arterial thrombosis. Mortality was the same in both cases (14.3%). ConclusionLT results with DCD-70 are similar to those of DBD-70, so the age criteria could also be extended in this type of donation.