Clinical transplantation and research · 2026
Outcomes of liver transplantation using extended criteria brain-dead donors: a retrospective study with initial experiences from a Vietnamese center.
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Hai Dang Do, Quang Nghia Nguyen, Viet Khai Ninh, Ha Phuong Tran, Hoang Tuan, Dinh Dung Tran, Duc Trung Nguyen, Quang Thang Le, Kim Dung Dao Thi, Quang Thuy Luu, Thi Lan Nguyen, Tien Quyet Nguyen, Duc Hung Duong
Аннотация
BACKGROUND: The persistent scarcity of deceased donor organs continues to limit liver transplantation (LT) worldwide. Extended criteria donors (ECD) represent a practical strategy to expand the donor pool; however, concerns remain regarding graft dysfunction and early mortality. This study aimed to evaluate clinical outcomes of LT using ECD grafts at Viet Duc University Hospital (2012-2023).
METHODS: A retrospective descriptive study was conducted using convenience sampling. All recipients who received ECD grafts were included and compared with recipients of standard criteria donor (SCD) grafts. Primary outcomes included early (≤90 days) and late (>3 months) postoperative complications, intensive care unit (ICU) and hospital length of stay, 90-day mortality, and overall survival (OS).
RESULTS: Of 65 LTs, 25 (38.5%) used ECD grafts. The most frequent ECD criterion was severe hypernatremia (>170 mmol/L; 36%). Recipients were predominantly male (93.8%), mean age of 52.1 years, mostly indicated for hepatocellular carcinoma on a background of hepatitis B infection (>80%). ICU stay (4.7 vs. 5.2 days, P=0.35), hospital stay (27.2 vs. 27.0 days, P=0.91), and overall complication rates did not differ significantly between groups. Early ECD complications included rejection (4%) and primary graft dysfunction (4%). Although 90-day mortality was higher in the ECD group (8% vs. 2.5%), it was not statistically significant. Long-term outcomes were comparable: 5- and 10-year OS rates were 83.1% and 66.5% in the ECD group versus 71.9% and 71.9% in the SCD group (P>0.05).
CONCLUSIONS: LT using ECD grafts provides comparable short- and mid-term survival to SCD grafts, despite a slightly increased risk of early severe complications.
METHODS: A retrospective descriptive study was conducted using convenience sampling. All recipients who received ECD grafts were included and compared with recipients of standard criteria donor (SCD) grafts. Primary outcomes included early (≤90 days) and late (>3 months) postoperative complications, intensive care unit (ICU) and hospital length of stay, 90-day mortality, and overall survival (OS).
RESULTS: Of 65 LTs, 25 (38.5%) used ECD grafts. The most frequent ECD criterion was severe hypernatremia (>170 mmol/L; 36%). Recipients were predominantly male (93.8%), mean age of 52.1 years, mostly indicated for hepatocellular carcinoma on a background of hepatitis B infection (>80%). ICU stay (4.7 vs. 5.2 days, P=0.35), hospital stay (27.2 vs. 27.0 days, P=0.91), and overall complication rates did not differ significantly between groups. Early ECD complications included rejection (4%) and primary graft dysfunction (4%). Although 90-day mortality was higher in the ECD group (8% vs. 2.5%), it was not statistically significant. Long-term outcomes were comparable: 5- and 10-year OS rates were 83.1% and 66.5% in the ECD group versus 71.9% and 71.9% in the SCD group (P>0.05).
CONCLUSIONS: LT using ECD grafts provides comparable short- and mid-term survival to SCD grafts, despite a slightly increased risk of early severe complications.