Department of Abdominal Surgery and Transplantation, CHU de Liège, University of Liège, Liège, Belgium.
Transpl Int. 2010 Jun;23(6):611-8. doi: 10.1111/j.1432-2277.2009.01029.x. Epub 2009 Dec 14.
The Belgian experience with donation after cardiac death (DCD) liver transplantation (LT) was retrospectively reviewed, particularly evaluating patient and graft survivals, and biliary complications. From 2003 to 2007, 58 DCD-LT were performed in Belgium. Mean procurement total warm ischemia time was 25 +/- 2 min (mean +/- SEM). Mean cold ischemia time was 451 +/- 18 min. Mean follow-up was 23 +/- 2.2 months. Post-transplant peak aspartate aminotransminases was 2241 +/- 338 UI/l. Patient survivals at 1 month, 1 and 3 years, were 91.3%, 83.3% and 66.9% respectively. Graft survivals at 1 month, 1 and 3 years, were 84.4%, 72.4% and 48.8% respectively. Two patients (3.4%) developed primary nonfunction. Regarding the biliary complications, seven grafts (12%) were lost because of intrahepatic cholangiopathy, and 12 other patients (20.6%) developed bile duct stenoses requiring endoscopic and/or surgical management. The rate of symptomatic ischemic biliary lesions for grafts surviving more than 3 months was 38% (19/50). Although DCD organ donors may be a source of viable liver grafts, results were inferior to those obtained with donation after brain death LT in this series. Prognostic criteria have to be developed to improve results of DCD-LT.
回顾性分析了比利时在心脏死亡后捐献（DCD）肝移植（LT）方面的经验，特别是评估了患者和移植物的存活率以及胆道并发症。2003 年至 2007 年，比利时共进行了 58 例 DCD-LT。平均采集总热缺血时间为 25±2 分钟（平均值±SEM）。平均冷缺血时间为 451±18 分钟。平均随访时间为 23±2.2 个月。移植后丙氨酸氨基转移酶峰值为 2241±338 UI/L。1 个月、1 年和 3 年的患者存活率分别为 91.3%、83.3%和 66.9%。1 个月、1 年和 3 年的移植物存活率分别为 84.4%、72.4%和 48.8%。2 例患者（3.4%）发生原发性无功能。关于胆道并发症，7 例移植物（12%）因肝内胆管炎而丢失，12 例其他患者（20.6%）发生胆管狭窄，需要内镜和/或手术治疗。在存活超过 3 个月的移植物中，症状性缺血性胆道病变的发生率为 38%（19/50）。尽管 DCD 供体可能是有活力的肝移植物的来源，但在本系列中，结果不如脑死亡 LT 获得的结果好。需要制定预测标准来改善 DCD-LT 的结果。
