Impact of reversible cardiac arrest in the brain-dead organ donor on the outcome of adult liver transplantation

✍ Scribed by Eric Levesque; Emir Hoti; Meriem Khalfallah; Chady Salloum; Luana Ricca; Eric Vibert; Daniel Azoulay

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 140 KB
• Volume: 17
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.22372

✦ Synopsis

Several donor and graft characteristics are associated with higher failure rates for deceased donor liver transplantation (LT). The influence of reversible cardiac arrest in the donor on these failure rates is unclear because of scarce and inconsistent data. The aim of this study was to determine whether reversible cardiac arrest in the donor could affect the early postoperative outcome of LT. From January 2008 to February 2010, 165 patients underwent LT, and they were retrospectively divided into 2 groups: a cardiac arrest group (34 patients who received grafts from donors who had experienced reversible cardiac arrest before organ procurement) and a control group (131 patients who received grafts from donors without a history of reversible cardiac arrest). The postoperative complications and the graft and recipient outcomes were prospectively recorded for all the patients. Graft failure was defined as death or the need for retransplantation within 90 days of LT. Donors in the cardiac arrest group displayed higher serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels than donors in the control group [AST: 104 (19-756) versus 42 IU/L (10-225 IU/L), P < 0.001; ALT: 73 (13-869) versus 29 IU/L (6-549 IU/L), P < 0.001]. However, no difference in the graft failure rates was found between the 2 groups (11.8% versus 8.4%, P ¼ 0.51). The biological parameters 5 and 7 days after LT and the peak AST/ALT levels were similar for the 2 groups. Furthermore, the 2 groups had similar graft and patient survival rates at the 6-month mark (87% and 88%, respectively). In conclusion, our study shows that brief and reversible cardiac arrest in organ donors does not affect post-LT allograft survival and function, even though liver function test values are higher for these donors. However, the risk of using these grafts needs to be balanced against the potential benefits for the recipients.