Author:
Pescarissi Claudia,Penzo Beatrice,Ghinolfi Davide,Lai Quirino,Bindi Lucia,DeCarlis Riccardo,Melandro Fabio,Balzano Emanuele,DeSimone Paolo,DeCarlis Luciano,DeGasperi Andrea,Amici Ombretta,Amorese Gabriella,Barbaglio Caterina,Belfiore Jacopo,Bisà Massimo,Brunetti Andrea,Camera Daniela,Nicolini Niccolò Castellani,Catalano Gabriele,Cibelli Eva,Colombo Stefania,Consani Giovanni,DiMatteo Simone,Esposito Massimo,Guffanti Elena,Mazza Ernestina,Mazzanti Tommaso,Meacci Luca,Molinari Pietro,Petrò Laura,Pratesi Giorgia,Prosperi Manlio,Puccini Francesca,Roselli Elena,Scaffidi Ilenia,Spelta Alicia,Taddei Riccardo,Tincani Giovanni,Torri Francesco,Biancofiore Giandomenico L.,
Abstract
AbstractBackgroundAs literature largely focuses on long-term outcomes, this study aimed at elucidating the perioperative outcomes of liver transplant patients receiving a graft from two groups of unconventional expanded criteria donors: brain dead aged > 80 years and cardiac dead.MethodsData of 247 cirrhotic patients transplanted at two high volume liver transplant centers were analysed. Confounders were balanced using a stabilized inverse probability therapy weighting and a propensity score for each patient on the original population was generated. The score was created using a multivariate logistic regression model considering a Comprehensive Complication Index ≥ 42 (no versus yes) as the dependent variable and 11 possible clinically relevant confounders as covariate.ResultsForty-four patients received the graft from a cardiac-dead donor and 203 from a brain-dead donor aged > 80 years. Intraoperatively, cardiac-dead donors liver transplant cases required more fresh frozen plasma units (P < 0.0001) with similar reduced need of fibrinogen to old brain-dead donors cases. The incidence of reperfusion syndrome was similar (P = 0.80). In the Intensive Care Unit, both the groups presented a comparable low need for blood transfusions, renal replacement therapy and inotropes. Cardiac-dead donors liver transplantations required more time to tracheal extubation (P < 0.0001) and scored higher Comprehensive Complication Index (P < 0.0001) however the incidence of a severe complication status (Comprehensive Complication Index ≥ 42) was similar (P = 0.52). ICU stay (P = 0.97), total hospital stay (P = 0.57), in hospital (P = 1.00) and 6 months (P = 1.00) death were similar.ConclusionSelected octogenarian and cardiac-dead donors can be used safely for liver transplantation.
Publisher
Springer Science and Business Media LLC
Subject
Anesthesiology and Pain Medicine
Cited by
2 articles.
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1. Impact of aging on peribiliary glands in ischemia–reperfusion injury;Journal of Hepato-Biliary-Pancreatic Sciences;2024-07-16
2. Extended criteria donors: opportunities and advances;Liver Transplantation - Challenges and Opportunities;2024-04-05