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Parente A, Milana F, Hajibandeh S, Hajibandeh S, Tirotta F, Cho HD, Kasahara M, Kim KH, Schlegel A. Clinical outcomes after transplantation of domino grafts or standard deceased donor livers: a systematic review and meta-analysis. J Gastroenterol Hepatol 2024; 39:620-629. [PMID: 38228293 DOI: 10.1111/jgh.16476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 11/01/2023] [Accepted: 12/18/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND AND AIM Domino liver transplantation (DLT) utilizes otherwise discarded livers as donor grafts for another recipients. It is unclear whether DLT has less favorable outcomes compared to deceased donor liver transplantation (DDLT). We aimed to assess the outcomes of DLT compared to DDLT. METHODS MEDLINE, Embase, and Web of Science database were searched to identify studies comparing outcomes after DLT with DDLT. Data were pooled using random-effects modeling, evaluating odds ratios (OR) or mean difference (MD) for outcomes including waiting list time, severe hemorrhage, intensive care unit (ICU), length hospital stay (LOS), rejection, renal, vascular, and biliary events, and recipient survival at 1, 3, 5, and 10 years. RESULTS Five studies were identified including 945 patients (DLT = 409, DDLT = 536). The DLT recipients were older compared to the DDLT group (P = 0.04), and both cohorts were comparable regarding lab MELD, hepatocellular carcinoma, and waitlist time. There were no differences in vascular (OR: 1.60, P = 0.39), renal (OR: 0.62, P = 0.24), biliary (OR: 1.51, P = 0.21), severe hemorrhage (OR: 1.09, P = 0.86), rejection (OR: 0.78, P = 0.51), ICU stay (MD: 0.50, P = 0.21), or LOS (MD: 1.68, P = 0.46) between DLT and DDLT. DLT and DDLT were associated with comparable 1-year (78.9% vs 80.4%; OR: 1.03, P = 0.89), 3-year (56.2% vs 54.1%; OR: 1.35, P = 0.07), and 10-year survival (6.5% vs 8.5%; OR: 0.8, P = 0.67) rates. DLT was associated with higher 5-year survival (41.6% vs 36.4%; OR: 1.70; P = 0.003) compared to DDLT, which was not confirmed at sensitivity analysis. CONCLUSION This meta-analysis of the best available evidence (Level 2a) demonstrated that DLT and DDLT have comparable outcomes. As indications for liver transplantation expand, future high-quality research is encouraged to increase the DLT numbers in clinical practice, serving the growing waiting list candidates, with the caveat of uncertain de novo disease transmission risks.
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Affiliation(s)
- Alessandro Parente
- Division of Hepatobiliary and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Flavio Milana
- Division of Hepatobiliary and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Shahin Hajibandeh
- Department of Hepatobiliary and Pancreatic Surgery, University Hospital Coventry, Coventry, UK
| | - Shahab Hajibandeh
- Department of Hepatobiliary and Pancreatic Surgery, University Hospital of Wales, Cardiff, UK
| | - Fabio Tirotta
- Department of Surgery, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Trust, Birmingham, UK
| | - Hwui-Dong Cho
- Division of Hepatobiliary and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Mureo Kasahara
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - Ki-Hun Kim
- Division of Hepatobiliary and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Andrea Schlegel
- Transplantation Center, Digestive Disease and Surgery Institute, Department of Immunology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Muhammad M, Tumin D. Parent Gender and Assessment of Children's Health. Clin Pediatr (Phila) 2024; 63:334-340. [PMID: 37148277 DOI: 10.1177/00099228231172669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Caregiver-reported data on children's health are typically provided by mothers. We investigated whether measures of children's health would significantly differ between mother and father respondents to a nationally representative survey. This study used de-identified data on children age 0 to 17 years from the 2016-2019 National Survey of Children's Health (NSCH). The primary exposure was whether the survey was completed by the child's father (cases) or mother (controls). Outcome variables included general health, special health care needs (SHCN), and unmet health care needs. We identified 85 191 children meeting inclusion criteria, of whom 35.1% had a father respondent. After propensity score matching, 27 738 children with a father respondent were matched to an equal size group of children with a mother respondent. On conditional logistic regression analysis of the matched sample, we found that poor health, SHCN, and unmet health care needs were less likely to be reported for children in the sample by father respondents.
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Affiliation(s)
- Mufida Muhammad
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Dmitry Tumin
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
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Rangaswamy B, Hughes CB, Sholosh B, Dasyam AK. Unconventional Strategies for Solid Organ Transplantation and Special Transplantation Scenarios. Radiol Clin North Am 2023; 61:901-912. [PMID: 37495296 DOI: 10.1016/j.rcl.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Solid organ transplantation is the only long-term therapeutic option for patients with end-organ failure but cadaveric and living donor transplant pools are unable to meet the demand for organ transplantation. Newer techniques, innovative strategies and altruistic donors can help bridge this wide gap between the number of organ donors and recipients. Domino liver transplantation, paired organ donation, and ABO incompatible transplants are some of the ways to ensure increased transplant organ availability. Split liver transplantation and ex vivo liver resection and auto transplantation are considered surgically challenging but are being done at tertiary transplant centers.
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Affiliation(s)
| | - Christopher B Hughes
- Department of Surgery, Liver Transplantation at the Thomas E. Starzl Transplantation Institute, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Biatta Sholosh
- Department of Radiology, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Anil K Dasyam
- Department of Radiology, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
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Buijk MS, van der Meer JBL, Ijzermans JNM, Minnee RC, Boehnert MU. Expanding the living donor pool using domino liver transplantation: a systematic review. HPB (Oxford) 2023:S1365-182X(23)00079-5. [PMID: 36935291 DOI: 10.1016/j.hpb.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 03/21/2023]
Abstract
INTRODUCTION To this day, a discrepancy exists between donor liver demand and supply. Domino liver transplantation (DLT) can contribute to increasing the number of donor livers available for transplantation. METHODS The design of this systematic review was based on the Preferred Reporting Items for Systematic Reviews (PRISMA). A qualitative analysis of included studies was performed. Primary outcomes were mortality and peri- and postoperative complications related to DLT. RESULTS Twelve studies met the inclusion criteria. All included studies showed that DLT outcomes were comparable to outcomes of deceased donor liver transplantation (DDLT) in terms of mortality and complications. One-year patient survival rate ranged from 66.7% to 100%. Re-transplantation rate varied from 0 to 12.5%. Most frequent complications were related to biliary (3.7%-37.5%), hepatic artery (1.6%-9.1%), portal vein (12.5-33.3%) and hepatic vein events (1.6%), recurrence of domino donor disease (3.3%-17.4%) and graft rejection (16.7%-37.7%). The quality of the evidence was rated as moderate according to the Newcastle-Ottawa scale (NOS). CONCLUSION DLT outcomes were similar to DDLT in terms of mortality and complications. Even though DLT will not solve the entire problem of organ shortage, transplant programs should always consider using this tool to maximize the availability of liver grafts.
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Affiliation(s)
- Mika S Buijk
- Erasmus MC Transplant Institute, Department of Surgery, Division of HPB & Transplant Surgery, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015GD, Rotterdam, Netherlands
| | - Job B L van der Meer
- Erasmus MC Transplant Institute, Department of Surgery, Division of HPB & Transplant Surgery, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015GD, Rotterdam, Netherlands
| | - Jan N M Ijzermans
- Erasmus MC Transplant Institute, Department of Surgery, Division of HPB & Transplant Surgery, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015GD, Rotterdam, Netherlands
| | - Robert C Minnee
- Erasmus MC Transplant Institute, Department of Surgery, Division of HPB & Transplant Surgery, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015GD, Rotterdam, Netherlands.
| | - Markus U Boehnert
- Erasmus MC Transplant Institute, Department of Surgery, Division of HPB & Transplant Surgery, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015GD, Rotterdam, Netherlands; King Faisal Specialist Hospital and Research Center, Organ Transplant Center of Excellence, Riyadh, 11211, Saudi Arabia
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5
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Ahmed O, Vachharajani N, Chang SH, Park Y, Khan AS, Chapman WC, Doyle MBM. Domino liver transplants: where do we stand after a quarter-century? A US national analysis. HPB (Oxford) 2022; 24:1026-1034. [PMID: 34924293 DOI: 10.1016/j.hpb.2021.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Domino liver transplantation (DLT) utilizes a phenotypically normal explant from select recipients as a donor graft in another patient. The procedure is not widely employed and remains restricted to a small number of centers. The purpose of this study was to assess the national profile of DLT in the United States (US) and evaluate current survival outcomes. METHODS The United Network for Organ Sharing (UNOS) database was queried for all liver transplants (LT) between 1996 and 2020. Outcomes of interest were long-term graft and patient survival. RESULTS Of 181,976 LTs performed nationally during the study period, 185 (0.1%) were DLTs. Amyloidosis and maple syrup urine disease (MSUD) accounted for 83% of dominoed allografts. Out of 210 explants with amyloidosis, 103 (49%) were dominoed into secondary recipients. Only 50 (22%) of all MSUD explants (n = 227) were dominoed. Graft survival was 79%, 73% and 53% at 3-, 5- and 10-years, respectively, for DLT recipients. Overall patient survival was 83%, 76% and 57% at 3-, 5- and 10-years. CONCLUSION Despite excellent long-term survival outcomes, DLT allografts comprise a very small percentage of the liver donor pool. A large proportion of potential DLTs may be unconscionably excluded despite shortages in deceased donor organs.
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Affiliation(s)
- Ola Ahmed
- Division of Abdominal Organ Transplantation, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - Neeta Vachharajani
- Division of Abdominal Organ Transplantation, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - Su-Hsin Chang
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Adeel S Khan
- Division of Abdominal Organ Transplantation, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - William C Chapman
- Division of Abdominal Organ Transplantation, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - M B M Doyle
- Division of Abdominal Organ Transplantation, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA.
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6
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Yamamoto H, Sambommatsu Y, Ishii M, Shimata K, Isono K, Honda M, Sugawara Y, Inomata Y, Hibi T. Surgical Outcomes of Domino Liver Transplantation Using Grafts From Living Donors With Familial Amyloid Polyneuropathy. Liver Transpl 2022; 28:603-614. [PMID: 34989109 DOI: 10.1002/lt.26401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/29/2021] [Accepted: 12/19/2021] [Indexed: 01/13/2023]
Abstract
Domino liver transplantation (DLT) using grafts from donors with familial amyloid polyneuropathy is an acceptable procedure for expanding the donor pool. The vascular and biliary reconstructions in living donor DLT (LDDLT) are technically demanding, and data on the short-term and long-term surgical outcomes of domino donors and recipients in LDDLT are limited. In this study, we identified 25 domino recipients from our liver transplantation program (1999-2018), analyzed the vascular and biliary reconstructions performed, and evaluated the surgical outcomes, including graft survival. Piggyback technique was adopted in all 25 domino donors. The only surgical complication in domino donors was hepatic vein (HV) stenosis with an incidence rate of 4%. In 22 domino recipients, right HV and middle/left HV were reconstructed separately. A total of 10 recipients had 2 arteries anastomosed, and 18 underwent duct-to-duct biliary anastomosis. HV stenosis and biliary stricture had incidence rates of 8% and 24%, respectively, in the recipients, but none of them developed hepatic artery thrombosis. The 1-year and 5-year graft survival rates were 100% each in the domino donors, and 84.0% and 67.3% in the domino recipients, respectively. In conclusion, LDDLT has acceptable outcomes without increasing the operative risk in donors despite the demanding surgical technique involved.
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Affiliation(s)
- Hidekazu Yamamoto
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Yuzuru Sambommatsu
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Masatsugu Ishii
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Keita Shimata
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Kaori Isono
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Masaki Honda
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Yasuhiko Sugawara
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | | | - Taizo Hibi
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
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Raghu VK, Carr-Boyd PD, Squires JE, Vockley J, Goldaracena N, Mazariegos GV. Domino transplantation for pediatric liver recipients: Obstacles, challenges, and successes. Pediatr Transplant 2021; 25:e14114. [PMID: 34448327 PMCID: PMC9759994 DOI: 10.1111/petr.14114] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/23/2021] [Accepted: 07/27/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Domino liver transplantation aims to address the need to increase the liver donor supply. In a domino liver transplant, the domino recipient receives the explanted liver from the recipient of a traditional liver transplant. The domino donor typically requires liver transplant to correct a metabolic disorder; the explanted liver thus has a single gene defect but otherwise normal structure and function. METHODS In this review, we detail the history of domino liver transplantation, appropriate domino donor indications, the technical advances to the surgical approach, current outcomes, and future opportunities. RESULTS Development of de novo disease in the domino recipient has relegated adult domino liver transplant to be considered a source of marginal donor livers. However, pediatric domino liver transplant has leveraged certain metabolic disorders, especially maple syrup urine disease, in which the liver enzyme deficiency can be compensated by the systemic presence of sufficient enzyme. Advances in the surgical aspects of assuring adequate length of vasculature have improved the safety of the procedure in both domino donors and recipients. CONCLUSIONS Pediatric domino liver transplant utilizing domino donors with specific metabolic liver diseases should be considered a viable live donor option for children awaiting liver transplant.
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Affiliation(s)
- Vikram K. Raghu
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, UPMC Children’s Hospital Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Peter D. Carr-Boyd
- Hillman Center for Pediatric Transplantation, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James E. Squires
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, UPMC Children’s Hospital Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jerry Vockley
- Division of Medical Genetics, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nicolas Goldaracena
- Division of Transplant Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, USA
| | - George V. Mazariegos
- Hillman Center for Pediatric Transplantation, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Karadagi A, Romano A, Renneus Guthrie V, Kjaernet F, Ericzon BG, Nowak G. Effects of a Domino Liver Transplantation Program on Patient Survival and Waiting List Time: A Single-Center Retrospective Study. Transplant Proc 2021; 53:2983-2992. [PMID: 34749995 DOI: 10.1016/j.transproceed.2021.09.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 08/22/2021] [Accepted: 09/22/2021] [Indexed: 11/29/2022]
Abstract
Explanted livers from patients with familial amyloid polyneuropathy have often been used for domino liver transplantation (DLT). This has expanded the organ pool for liver transplantation. We evaluated the effects of a single-center DLT program on waiting list duration and patient survival. Liver transplants conducted from 2007 to 2017 were analyzed. Selected patients, all liver transplant candidates above the age of 60 years and patients with hepatocellular carcinoma, were offered DLT. Survival, time on waiting list, and operative factors were evaluated. The study group included 485 patients transplanted with grafts from deceased donors (conventional liver transplantation) and 149 patients who were offered and accepted a potential DLT, of whom 34 underwent DLT and 115 did not; these patients received a deceased donor graft (non-DLT). Five-year and overall estimated survival rates respectively were 79% and 54.4% for DLT and 67.6% and 46.7% for non-DLT (P = .67, log rank test). No differences were noted in survival (P = .816) or waiting times (P = 1.0) between DLT and non-DLT groups. As expected, survival time in the conventional liver transplantation group was longer (84.7% and 60.6%, P < .001). Donor age and ischemia time were significantly different between DLT and non-DLT (P < .001). DLT has enabled 6% additional transplantations without affecting waiting time or survival (34/600).
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Affiliation(s)
- Ahmad Karadagi
- Department of Transplantation Surgery, Karolinska University Hospital Huddinge, Stockholm, Sweden; Division of Transplantation Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
| | - Antonio Romano
- Department of Transplantation Surgery, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Viktor Renneus Guthrie
- Department of Transplantation Surgery, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Felicia Kjaernet
- Department of Transplantation Surgery, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Bo-Göran Ericzon
- Department of Transplantation Surgery, Karolinska University Hospital Huddinge, Stockholm, Sweden; Division of Transplantation Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Greg Nowak
- Department of Transplantation Surgery, Karolinska University Hospital Huddinge, Stockholm, Sweden; Division of Transplantation Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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Ronald McDonald House accommodation and parental presence in the neonatal intensive care unit. J Perinatol 2021; 41:2570-2572. [PMID: 34050245 DOI: 10.1038/s41372-021-01115-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/03/2021] [Accepted: 05/18/2021] [Indexed: 11/08/2022]
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Panichella J, Curtis H, Nguyen K, Resweber C, Gunder M, Di Carlo A, Karhadkar S. High and Low Frequency Domino Liver Transplantation Centers Demonstrate Similar Performance Outcomes. J Surg Res 2021; 269:144-150. [PMID: 34563840 DOI: 10.1016/j.jss.2021.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION A Domino Liver Transplant (DLT) is a successfully validated surgical option for a subset of patients awaiting liver transplant. Increased utilization of DLTs could increase the donor organ pool. However, DLTs occur primarily at a small number of high volume centers, and are rarely performed at lower volume transplant centers. This study compares DLT recipient performance outcomes between high frequency DLT centers and low frequency DLT centers. METHODS The UNOS/OPTN STAR database was queried for DLTs performed at transplant centers between 1996-2018. 193 patients were identified and categorized into high (>5 DLTs) or low (≤5 DLTs) frequency centers. Our primary endpoint was allograft survival. Our secondary endpoints were graft status at last follow up and mortality secondary to cardiac, renal, or respiratory failure. RESULTS Overall median allograft survival between high and low volume DLT centers was similar (48.2 months versus 42.7 months, P >0.314). The one-year (82% versus 76%), three-year (57% versus 56%), and five-year (45% versus 43%) survival percentages were also similar between the high and low volume DLT centers respectively. Overall mortality from cardiac (high 4% versus low 1.7%), renal (high 0.8% versus low 1.7%), or respiratory failure (high 0.8% versus low 1.7%) was similarly low in both groups. CONCLUSION Low volume and high volume DLT centers are associated with similar outcomes of allograft survival and mortality. DLTs should be utilized more frequently, when the criteria are met, including in centers with limited experience, to expand the donor pool, decrease time on the waitlist, and improve overall survival. DISCLOSURES There are no disclosures. The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.
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Affiliation(s)
- Juliet Panichella
- Temple University, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.
| | - Houston Curtis
- Temple University, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Kaitlin Nguyen
- Temple University, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Clay Resweber
- Temple University, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Meredith Gunder
- Temple University, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Anthony Di Carlo
- Temple University, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Sunil Karhadkar
- Temple University, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
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Lerut J, Foguenne M, Lai Q, de Ville de Goyet J. Domino-liver transplantation: toward a safer and simpler technique in both donor and recipient. Updates Surg 2020; 73:223-232. [PMID: 32965591 PMCID: PMC7889565 DOI: 10.1007/s13304-020-00886-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/04/2020] [Indexed: 11/29/2022]
Abstract
Domino-liver transplantation represents a rare chance to expand the donor liver pool. Fear of putting both donor and recipient at disadvantage has meant that the procedure has not been applied universally. A modification of the original technique which allows both safe procurement of the graft as well as safe implantation of the reconstructed graft in the domino-graft recipient using a 180° rotated, adequately trimmed, free iliaco-caval venous graft is described in detail.
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Affiliation(s)
- Jan Lerut
- Institute for Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCL), Avenue Hippocrate 55, 1200, Brussels, Belgium.
| | - Maxime Foguenne
- Institute for Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCL), Avenue Hippocrate 55, 1200, Brussels, Belgium
| | - Quirino Lai
- Liver Transplant Program, Sapienza University of Rome, Rome, Italy.
| | - Jean de Ville de Goyet
- University Pittsburgh Medical Center (UPMC-Italy) at the ISMETT (Istituto Mediterraneo for Trapianto e Terapie ad Alta Specializzazione), IRCCS, Palermo, Italy
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Santopaolo F, Lenci I, Bosa A, Angelico M, Milana M, Baiocchi L. Domino Liver Transplantation: Where are we Now? Rev Recent Clin Trials 2020; 14:183-188. [PMID: 30894112 DOI: 10.2174/1574887114666190320123824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/04/2019] [Accepted: 03/15/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Domino transplant occurs when a recipient explanted graft is used for a second recipient. INTRODUCTION The first experience came from thoracic surgery by the observation that many patients during heart-lung transplantation actually showed a functional heart that could be employed in other subjects with a good result. RESULTS This concept was then extended to the field of liver transplantation. At present, some patients transplanted for an inborn metabolic disease may be considered as excellent domino liver donors. CONCLUSION The results, limitations, clinical challenges and the donor and recipient features of domino liver transplantation are discussed in this manuscript.
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Affiliation(s)
- Francesco Santopaolo
- Unita Operativa di Epatologia, Policlinico Universitario di "Tor Vergata"; Viale Oxford 81, 00133 Rome, Italy
| | - Ilaria Lenci
- Unita Operativa di Epatologia, Policlinico Universitario di "Tor Vergata"; Viale Oxford 81, 00133 Rome, Italy
| | - Alessandra Bosa
- Unita Operativa di Epatologia, Policlinico Universitario di "Tor Vergata"; Viale Oxford 81, 00133 Rome, Italy
| | - Mario Angelico
- Unita Operativa di Epatologia, Policlinico Universitario di "Tor Vergata"; Viale Oxford 81, 00133 Rome, Italy
| | - Martina Milana
- Unita Operativa di Epatologia, Policlinico Universitario di "Tor Vergata"; Viale Oxford 81, 00133 Rome, Italy
| | - Leonardo Baiocchi
- Unita Operativa di Epatologia, Policlinico Universitario di "Tor Vergata"; Viale Oxford 81, 00133 Rome, Italy
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13
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Current update in domino liver transplantation. Int J Surg 2020; 82S:163-168. [PMID: 32244002 DOI: 10.1016/j.ijsu.2020.03.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 03/09/2020] [Accepted: 03/12/2020] [Indexed: 12/14/2022]
Abstract
Orthotopic liver transplantation is an established treatment for end stage liver diseases as well as for some severe metabolic disorders. With increasing number of patients on the waiting list and the ongoing shortage of livers available, domino liver transplantation (DLT) became an option to further expand the organ donor pool. DLT utilizes the explanted liver of one liver transplant recipient as a donor graft in another patient. Despite being a surgically, and logistically demanding procedure, excellent results could be achieved in experienced high-volume transplant centers. In this review we present the current world status of DLT.
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14
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Domino liver transplantation: the risk of disease recurrence. Clin Res Hepatol Gastroenterol 2019; 43:510-512. [PMID: 30773354 DOI: 10.1016/j.clinre.2019.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/21/2019] [Indexed: 02/04/2023]
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15
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Spada M, Angelico R, Dionisi-Vici C. Maple Syrup Urine Disease and Domino Liver Transplantation: When and How? Liver Transpl 2019; 25:827-828. [PMID: 31038782 DOI: 10.1002/lt.25481] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 04/25/2019] [Indexed: 01/13/2023]
Affiliation(s)
- Marco Spada
- Division of Abdominal Transplantation and Hepatobiliopancreatic Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Roberta Angelico
- Division of Abdominal Transplantation and Hepatobiliopancreatic Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Carlo Dionisi-Vici
- Division of Metabolism, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
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16
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First case report of domino living donor liver transplantation in Korea. TRANSPLANTATION REPORTS 2019. [DOI: 10.1016/j.tpr.2019.100030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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17
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Bechstein WO, Schnitzbauer AA. Do you really know what you get: the benefits and doubts of domino liver transplantation. Transpl Int 2018; 31:1198-1199. [PMID: 30152892 DOI: 10.1111/tri.13339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 08/24/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Wolf O Bechstein
- Department of General and Visceral Surgery, Frankfurt University Hospital and Clinics, Goethe University, Frankfurt am Main, Germany
| | - Andreas A Schnitzbauer
- Department of General and Visceral Surgery, Frankfurt University Hospital and Clinics, Goethe University, Frankfurt am Main, Germany
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