How do the outcomes of liver transplantation using allografts from non–heart beating donors (NBHDs) compare with those from heart-beating donors (HBDs) for patients with cirrhosis?

Updated: Jul 30, 2018
  • Author: David C Wolf, MD, FACP, FACG, AGAF, FAASLD; Chief Editor: BS Anand, MD  more...
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Answer

A review comparing the results of liver transplantation using allografts from 144 NHBDs and 26,856 HBDs over an 8-year period found better outcomes in HBD transplant recipients. [66] One- and 3-year graft survival rates were 70% and 63%, respectively, with organs from NHBDs, as opposed to 80% and 72%, respectively, with organs from HBDs. Higher rates of primary nonfunction and retransplantation were seen in the recipients of allografts from NHBDs.

Other authors have described a higher incidence of hepatic artery stenosis, hepatic abscesses, and bilomas in the recipients of allografts from NHBDs. [67] It is possible that improved results will be seen by limiting donor age, by minimizing donor warm ischemia time, and by not attempting to transplant livers from NHBDs into recipients who are severely ill.


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