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

592.1

44.7 – 701.8-2.5

RECIPIENTS Age (years)Lab MELD

58.515

51.7-6411-20

RECIPIENTS indication HCC on cirrhotic liverOther cancers

Cirrhosis without cancerReTx for HAT

266

362

PROCEDURESDWIT (min)

Withdrawal phase (min)Acirculatory phase

19.5119

16 – 247-15.58-10

CIT (min)Total ischemia

235.5292

200-285268-340

- 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