Open access

Donation after circulatory death (DCD) liver transplantation (LT) has been
introduced to partially overcome the organ donor shortage
DCD LT has lower graft survival due to increase rates of primary non-function and
graft loss due to ischemic cholangiopathy with difficult to treat non-anastomotic
biliary strictures
Aim: Report the authors‘ experience in DCD-LT, with a short cold ischemia time and
without upper limit age criteria
-Retrospective 10 years monocentric experience
-Center-oriented allocation within the Eurotransplant organisation
-No upper limit DCD donor age criteria
-70 consecutive DCD-LT
-DCD in OR, with heparin and donor comfort therapy
-Death on circulatory criteria
-5 min no-touch period
IS ULTRA-SHORT COLD ISCHEMIA THE KEY TO ISCHEMIC CHOLANGIOPATHY AVOIDANCE IN DCD-LT?
O Detry, A Deroover, S Cheham, H Ledinh, C Coimbra, E Decker, L Kohnen, MF Hans, J Joris, S Lauwick, A
Kaba, J Delwaide, M Meurisse, P Honoré University of Liege, CHU Liege, Belgium

Median n IQR
DONORS Age (years)
DRI
59
2.1 44.7 –70 1.8-2.5
RECIPIENTS Age (years)
Lab MELD
58.5
15 51.7-64 11-20
RECIPIENTS
indication HCC on cirrhotic liver
Other cancers
Cirrhosis without cancer
ReTx for HAT
26
6
36
2
PROCEDURES
DWIT
(min)
Withdrawal phase (min)
Acirculatory
phase
19.5
11
9
16 –24
7-15.5
8-10
CIT (min)
Total
ischemia 235.5 292 200-285 268-340

-DCD may be a valuable source of liver grafts
-DWIT < 30 min & CIT < 5 hours may lead to a low rate of graft loss due to PNF and/or ischemic
cholangiopathy
-With DWIT < 30 min & CIT < 5 hours, DCD donors > 60 years sould be considered to really
increase the cadaveric donor pool
Median
/n/%
Peak
AST (UI/L)
1,163
702
-2,810
Peak
total bili (mg/dL)
30.4
18.6
-62.2
PNF (n)
0
HAT (n)
1
1
year graft survival
91.3%
3
year graft survival
77.7%
Graft
loss
HAT: 1, cancer: 8, MOF: 4,
other
: 2
Intrahepatic
symptomatic NA stricture
0