Abstract:
Objective To discuss the curative effect and initial experience of liver transplantation (LT) from organ donation by citizens after death.
Methods Clinical data of 63 donors and 63 recipients who underwent LT from organ donation by citizens after death in the Third Affiliated Hospital of Sun Yat-sen University from July 2012 to April 2014 were analyzed retrospectively. The informed consents of donor family members and recipients were obstained and the ethical committee approval had been received. Among the donors, 50 were males and 13 were females with the age ranging from 3 to 57 years old and the median of 29 years old. According to the category for China organ donation after cardiac death, 27 donors were donation after brain death (DBD, C-Ⅰ), 32 were donation after cardiac death (DCD, C-Ⅱ), and 4 were donation after brain and cardiac death (DBCD, C-Ⅲ). Among the recipients, 53 were males and 10 were females with the age ranging from 6 to 74 years old and the median of 42 years old. In order to obtain applicative donor liver, training on discovering potential donors was strengthened, organ function of potential donors was actively maintained and fast, normalized organ procurement skills were carried out. The conditions during the perioperative period and the prognosis during the follow-up period of the recipients were observed.
Results All the 63 recipients underwent LT successfully. The median ICU stay was 3(2-7) d and the postoperative hospital stay was 28(25-40) d. Perioperative death was observed in 5 cases, in which 2 cases died of primary graft failure and the other 3 cases died of infection and multiple organ failure. After operation, 1 patient suffered from arterial anastomotic stenosis, 1 suffered from ischemic cholangitis and 2 suffered from biliary anastomotic stenosis. The recipients were followed up for 8-34 months. Two cases died of tumor recurrence and metastasis. The liver function of the rest recipients recovered successfully with good prognosis.
Conclusions Reasonable and effective use of organ donation by citizens after death can expand the sources of donor liver. The recent curative effect of recipients is good. Strengthening of training on discovering potential donors, active maintenance of organ function of potential donors and fast, normalized organ procurement skills are important factors to ensure the quality of donor liver.
Key words:
Organ donation,
Liver transplantation,
Tissue and Organ procurement,
Organ function maintenance,
Prognosis
Binsheng Fu, Huimin Yi, Shuhong Yi, Hui Tang, Tong Zhang, Wei Meng, Guoying Wang, Nan Jiang, Genshu Wang, Jian Zhang, Chi Xu, Hua Li, Yang Yang, Guihua Chen. Single-center analysis on curative effect of liver transplantation from organ donation by citizens after death and initial experience[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2015, 04(02): 88-91.