Single-center experience with liver transplantation from controlled non-heartbeating donors: a viable source of grafts.

摘要: The demand for liver transplantation (OLT) has led to an increasing discrepancy between the number of potential candidates and organ availability. Diverse strategies have been successfully implemented try improve supply including use marginal, split, living, domino donor grafts. Following successful kidney grafts from non-heartbeating donors (NHBDs) transplantation,1 interest extended include liver, pancreas, lung.2,3 NHBDs are patients with brain injury incompatible recovery whose condition does not meet formal criteria brainstem death cardiopulmonary function ceases before organs retrieved. In 1960s, were main source allografts until Harvard neurologic definition published in 1968. introduction criteria, NHBD declined because better results obtained heartbeating organs. Renewed as a occurred shortage improvements preservation, immunosuppression, surgical techniques. NHBD can be categorized into 2 groups: controlled uncontrolled donors. Controlled donation takes place when occurs within intensive care unit (ICU)/hospital setting there is planned withdrawal therapy by patient's medical team. Uncontrolled outside hospital or emergency room resuscitation continuing unpredictable. ethics, assessment, techniques retrieval, outcome transplant very different these groups. NHBDs further 4 groups4 according location modality death. Experience transplants shown no difference long-term dead donors, although incidence delayed significantly higher former.5–7 Whereas managed dialysis, this possible recipients if primary nonfunction (PNF) severe dysfunction occur, retransplantation only rescue therapy. There relatively few reports regarding OLT NHBDs, but progressive reduction PNF recent years due shift towards restriction selection shorter warm cold ischemic times.8,9 2001, program was started on background long-standing based our region since 1988. A protocol retrieval evaluation livers developed, ethical committee approval institution prospective hospitals zone.