Donation After Cardiac Death in Liver Transplantation: An Additional Source of Organs With Similar Results to Donation After Brain Death

Abstract Background As new sources of organs are needed, liver transplantation using donors after cardiac death (DCD) is progressively increasing, but outcomes with this method are still questioned. This study was accomplished to verify that DCD outcomes are comparable to those seen in donation after brain death (DBD). Methods This was a prospective cohort study including 100 liver transplantation performed between 2014 and 2017, divided according to donor type in 75 DBD and 25 DCD. Results DCD donors were younger (mean age: DCD 56 years, DBD 59 years; P  = .009). Mean Modified End-stage Liver Disease (MELD) score was lower for DCD (DCD 16, DBD 19; P P  = .006). Rates of primary graft nonfunction (DCD 0%, DBD 1.3%; P  = .562) and acute rejection (DCD 20%, DBD 16.4%; P  = .685) were similar. Acute kidney injury occurred more often in DBD (DCD 32%, DBD 12%; P  = .051). Length of stay was comparable. Rates of biliary complications (DCD 20%, DBD 26.7%; P  = .505) were similar, unlike ischemic cholangiopathy (DCD 12%, DBD 1.3%; P  = .018). Retransplantation rates were also similar (DCD 8%, DBD 4%; P  = .427) as was survival rate after 3 years (DCD 84%, DBD 86.7%; P  = .739). Conclusion DCD represents an additional graft source with results that are encouraging and may be comparable to DBD with a careful donor and recipient selection.