Liver Transplantation from Voluntary Organ Donor System in China: A Comparison between DBD and DCD Liver Transplants

Background. In China, the cases of liver transplantation (LT) from donation after citizens’ death have rose year by year since the citizen-based voluntary organ donor system was initiated in 2010. The objective of our research was to investigate the early postoperative and late long-term outcomes of...

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Main Authors: Wei Chen, Dipesh Kumar Yadav, Xueli Bai, Jianying Lou, Risheng Que, Shunliang Gao, Guogang Li, Tao Ma, Ji Wang, Bingfeng Huang, Tingbo Liang
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2019/5736702
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author Wei Chen
Dipesh Kumar Yadav
Xueli Bai
Jianying Lou
Risheng Que
Shunliang Gao
Guogang Li
Tao Ma
Ji Wang
Bingfeng Huang
Tingbo Liang
author_facet Wei Chen
Dipesh Kumar Yadav
Xueli Bai
Jianying Lou
Risheng Que
Shunliang Gao
Guogang Li
Tao Ma
Ji Wang
Bingfeng Huang
Tingbo Liang
author_sort Wei Chen
collection DOAJ
description Background. In China, the cases of liver transplantation (LT) from donation after citizens’ death have rose year by year since the citizen-based voluntary organ donor system was initiated in 2010. The objective of our research was to investigate the early postoperative and late long-term outcomes of LT from donation after brain death (DBD) and donation after circulatory death (DCD) according to the current organ donation system in China. Methods. Sixty-two consecutive cases of LT from donation after citizens’ death performed in our hospital between February 2012 and June 2017 were examined retrospectively for short- and long-term outcomes. These included 35 DCD LT and 27 DBD LT. Result. Subsequent median follow-up time of 19 months and 1- and 3-year graft survival rates were comparative between the DBD group and the DCD group (81.5% and 66.7% versus 67.1% and 59.7%; P=0.550), as were patient survival rates (85.2% and 68.7% versus 72.2% and 63.9%; P=0.358). The duration of ICU stay of recipients was significantly shorter in the DBD group, in comparison with that of the DCD group (1 versus 3 days, P=0.001). Severe complication incidence (≥grade III) after transplantation was identical among the DBD and DCD groups (48.1% versus 60%, P=0.352). There was no significant difference in postoperative mortality between the DBD and DCD groups (3 of 27 cases versus 5 of 35 cases). Twenty-one grafts (33.8%) were lost and 18 recipients (29.0%) were dead till the time of follow-up. Malignancy recurrence was the most prevalent reason for patient death (38.8%). There was no significant difference in incidence of biliary stenosis between the DBD and DCD groups (5 of 27 cases versus 6 of 35 cases, P=0.846). Conclusion. Although the sample size was small to some extent, this single-center study first reported that LT from DCD donors showed similar short- and long-term outcomes with DBD donors and justified the widespread implementation of voluntary citizen-based deceased organ donation in China. However, the results should be verified with a multicenter larger study.
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spelling doaj-art-a595b4d11ab543c3879f7a269cc48a312025-02-03T00:59:58ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/57367025736702Liver Transplantation from Voluntary Organ Donor System in China: A Comparison between DBD and DCD Liver TransplantsWei Chen0Dipesh Kumar Yadav1Xueli Bai2Jianying Lou3Risheng Que4Shunliang Gao5Guogang Li6Tao Ma7Ji Wang8Bingfeng Huang9Tingbo Liang10Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, ChinaDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, ChinaDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, ChinaBackground. In China, the cases of liver transplantation (LT) from donation after citizens’ death have rose year by year since the citizen-based voluntary organ donor system was initiated in 2010. The objective of our research was to investigate the early postoperative and late long-term outcomes of LT from donation after brain death (DBD) and donation after circulatory death (DCD) according to the current organ donation system in China. Methods. Sixty-two consecutive cases of LT from donation after citizens’ death performed in our hospital between February 2012 and June 2017 were examined retrospectively for short- and long-term outcomes. These included 35 DCD LT and 27 DBD LT. Result. Subsequent median follow-up time of 19 months and 1- and 3-year graft survival rates were comparative between the DBD group and the DCD group (81.5% and 66.7% versus 67.1% and 59.7%; P=0.550), as were patient survival rates (85.2% and 68.7% versus 72.2% and 63.9%; P=0.358). The duration of ICU stay of recipients was significantly shorter in the DBD group, in comparison with that of the DCD group (1 versus 3 days, P=0.001). Severe complication incidence (≥grade III) after transplantation was identical among the DBD and DCD groups (48.1% versus 60%, P=0.352). There was no significant difference in postoperative mortality between the DBD and DCD groups (3 of 27 cases versus 5 of 35 cases). Twenty-one grafts (33.8%) were lost and 18 recipients (29.0%) were dead till the time of follow-up. Malignancy recurrence was the most prevalent reason for patient death (38.8%). There was no significant difference in incidence of biliary stenosis between the DBD and DCD groups (5 of 27 cases versus 6 of 35 cases, P=0.846). Conclusion. Although the sample size was small to some extent, this single-center study first reported that LT from DCD donors showed similar short- and long-term outcomes with DBD donors and justified the widespread implementation of voluntary citizen-based deceased organ donation in China. However, the results should be verified with a multicenter larger study.http://dx.doi.org/10.1155/2019/5736702
spellingShingle Wei Chen
Dipesh Kumar Yadav
Xueli Bai
Jianying Lou
Risheng Que
Shunliang Gao
Guogang Li
Tao Ma
Ji Wang
Bingfeng Huang
Tingbo Liang
Liver Transplantation from Voluntary Organ Donor System in China: A Comparison between DBD and DCD Liver Transplants
Gastroenterology Research and Practice
title Liver Transplantation from Voluntary Organ Donor System in China: A Comparison between DBD and DCD Liver Transplants
title_full Liver Transplantation from Voluntary Organ Donor System in China: A Comparison between DBD and DCD Liver Transplants
title_fullStr Liver Transplantation from Voluntary Organ Donor System in China: A Comparison between DBD and DCD Liver Transplants
title_full_unstemmed Liver Transplantation from Voluntary Organ Donor System in China: A Comparison between DBD and DCD Liver Transplants
title_short Liver Transplantation from Voluntary Organ Donor System in China: A Comparison between DBD and DCD Liver Transplants
title_sort liver transplantation from voluntary organ donor system in china a comparison between dbd and dcd liver transplants
url http://dx.doi.org/10.1155/2019/5736702
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