Does Time to Asystole in Donors After Circulatory Death Impact Recipient Outcome in Liver Transplantation? Article Swipe
Abdullah Malik
,
Samuel J Tingle
,
Chris Varghese
,
Ruth Owen
,
Balaji Mahendran
,
Rodrigo Figueiredo
,
Aimen Amer
,
Ian Currie
,
Steven A. White
,
Derek Manas
,
Colin Wilson
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1097/tp.0000000000005074
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1097/tp.0000000000005074
Background. The agonal phase can vary following treatment withdrawal in donor after circulatory death (DCD). There is little evidence to support when procurement teams should stand down in relation to donor time to death (TTD). We assessed what impact TTD had on outcomes following DCD liver transplantation. Methods. Data were extracted from the UK Transplant Registry on DCD liver transplant recipients from 2006 to 2021. TTD was the time from withdrawal of life-sustaining treatment to asystole, and functional warm ischemia time was the time from donor systolic blood pressure and/or oxygen saturation falling below 50 mm Hg and 70%, respectively, to aortic perfusion. The primary endpoint was 1-y graft survival. Potential predictors were fitted into Cox proportional hazards models. Adjusted restricted cubic spline models were generated to further delineate the relationship between TTD and outcome. Results. One thousand five hundred fifty-eight recipients of a DCD liver graft were included. Median TTD in the entire cohort was 13 min (interquartile range, 9–17 min). Restricted cubic splines revealed that the risk of graft loss was significantly greater when TTD ≤14 min. After 14 min, there was no impact on graft loss. Prolonged hepatectomy time was significantly associated with graft loss (hazard ratio, 1.87; 95% confidence interval, 1.23-2.83; P = 0.003); however, functional warm ischemia time had no impact (hazard ratio, 1.00; 95% confidence interval, 0.44-2.27; P > 0.9). Conclusions. A very short TTD was associated with increased risk of graft loss, possibly because of such donors being more unstable and/or experiencing brain stem death as well as circulatory death. Expanding the stand down times may increase the utilization of donor livers without significantly impairing graft outcome.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1097/tp.0000000000005074
- OA Status
- hybrid
- Cited By
- 1
- References
- 61
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4398252071
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4398252071Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1097/tp.0000000000005074Digital Object Identifier
- Title
-
Does Time to Asystole in Donors After Circulatory Death Impact Recipient Outcome in Liver Transplantation?Work title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-05-21Full publication date if available
- Authors
-
Abdullah Malik, Samuel J Tingle, Chris Varghese, Ruth Owen, Balaji Mahendran, Rodrigo Figueiredo, Aimen Amer, Ian Currie, Steven A. White, Derek Manas, Colin WilsonList of authors in order
- Landing page
-
https://doi.org/10.1097/tp.0000000000005074Publisher landing page
- Open access
-
YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
-
https://doi.org/10.1097/tp.0000000000005074Direct OA link when available
- Concepts
-
Medicine, Interquartile range, Asystole, Hazard ratio, Confidence interval, Liver transplantation, Transplantation, Proportional hazards model, Cardiology, Internal medicine, Ischemia, Surgery, AnesthesiaTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
1Total citation count in OpenAlex
- Citations by year (recent)
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2024: 1Per-year citation counts (last 5 years)
- References (count)
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61Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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