Clinical effect analysis of liver transplantation from donation after citizen's death in 31 cases

  Objective  To summarize the clinical experience and curative effect analysis of liver transplantation from donation after citizen's death.

  Methods  Clinical data of 31 cases of liver transplantation from donation after citizen's death in the 303^rd Hospital of People's Liberation Army were retrospectively studied.

  Results  Among the 31 donors, 8 donors met ClassⅠof Chinese Standard, 3 met Class Ⅱ and 20 met Class Ⅲ. The liver graft was obtained according to the standardized organ procurement process. The warm ischemia time of the liver graft was 2-13 min with the average of 9 min and the cold ischemia time was 240-600 min with the average of 350 min. Thirty-one recipients underwent the liver transplantation successfully. Twenty-nine recipients recovered well and the liver function gradually recovered without thrombosis and rejection. Four recipients developed biliary stricture and the drainage was unobstructed after biliary stent placement. The average stay time in intensive care unit (ICU) was 8 d and the average length of stay after transplantation was 21 d. The recipients were discharged when the conditions were stable. The overall survival rate of the recipients was 81%. One recipient died of primary liver dysfunction at 2 d after transplantation, one recipient died of postoperative pulmonary infection and four tumor patients died of tumor recurrence and metastasis.

  Conclusions  Donation after citizen's death may expand the source of liver grafts and the short term effect is good. To gradually improve function protective measures for donor organs, to strictly control indications of donors, to strengthen the assessment of organ function and to shorten warm and cold ischemia time are important measures to improve clinical effect.