Liver transplantation using grafts from brain dead donors:a report of 9 cases

Objective To study the short and medium-term outcomes of liver transplant patients receiving grafts from brain dead donors and summarize the clinical experience. Methods The clinical data of 9 cases of liver transplant recipients with brain dead liver grafts in the Transplant Center,First Affiliated Hospital of Sun Yat-sen University were retrospectively studied. The donors aged from 16 to 43 years,of which 7 died from brain trauma and 2 from cerebrovascular accident. Mean arterial pressure (MAP) of the donors was (105±5.2) mmHg (1 mmHg=1.333 kPa) before organ harvesting,6 of which needed vasopressors. Their liver function was (175±40) U/L of aspartate aminotransferase,(180±46) U/L of alanine aminotransferase,and (40±8.6) mmol/L of total bile acid. The recipients aged (48.6±10.1) years,5 with liver cirrhosis and 4 with hepatocellular carcinoma. Their MELD scores before transplantation was 27.6±6.7.Results All operations were successful with a mean cold ischemia time of (7.4±2.8) hours. One patient died of renal failure on the 7th day post-transplantation,the other 8 patients recovered well and were followed up for 6 to 24 months after discharge. One patient died from tumor recurrence in the 24th month after operation. Other complications included acute rejection in 2 cases,biliary anastomosis stenosis combining infection in 1 case,biliary track ischemia in 1 case,and lung infection in 1 case,which were all controlled by conservative treatment.Conclusion The short and medium-term outcomes of the recipients and grafts are acceptable,which indicates that brain death liver grafts are suitable for liver transplantation in our country.