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Liver Transplantation From Uncontrolled DCD Donors

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Donation after Circulatory Death (DCD) Liver Transplantation

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Abstract

Uncontrolled donation after circulatory death (uDCD) donors suffer sudden and unanticipated cardiac arrest, typically outside the hospital setting. After advanced cardiopulmonary resuscitation has been attempted and determined to be unsuccessful, uDCD may be considered. At present, all programs recovering and transplanting uDCD livers rely on postmortem normothermic regional perfusion (NRP) to restore the flow of oxygenated blood following declaration of death. In this chapter, we discuss different aspects related to liver transplantation uDCD donors, including logistical and ethical issues surrounding the uDCD process, the use of NRP, graft and recipient selection criteria, perioperative recipient management, and post-transplantation outcomes that have been reported to date. We aim to demonstrate that, while uDCD is complex and the yield of livers for transplantation remains relatively low, it is nonetheless a viable alternative to more standard forms of liver donation and one that may be able to be expanded in the coming years through advances in both donor maintenance and ex situ organ preservation.

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Authors and Affiliations

  1. Department of Hepatopancreatobiliary Surgery and Transplantation, Hospital Clínic, IDIBAPS, CIBEREHD, University of Barcelona, Barcelona, Spain

    Amelia J. Hessheimer, Alba Torroella & Constantino Fondevila

Authors
  1. Amelia J. Hessheimer
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  2. Alba Torroella
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  3. Constantino Fondevila
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Correspondence to Constantino Fondevila .

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Editors and Affiliations

  1. Department of Transplant, Mayo Clinic, Jacksonville, FL, USA

    Kristopher P. Croome

  2. Queen Elizabeth Hospital Birmingham, Birmingham, UK

    Paolo Muiesan

  3. Department of Transplant, Mayo Clinic, Jacksonville, FL, USA

    C. Burcin Taner

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Hessheimer, A.J., Torroella, A., Fondevila, C. (2020). Liver Transplantation From Uncontrolled DCD Donors. In: Croome, K., Muiesan, P., Taner, C. (eds) Donation after Circulatory Death (DCD) Liver Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-030-46470-7_16

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  • DOI: https://doi.org/10.1007/978-3-030-46470-7_16

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