Analyze The Risk Factors Of The Recipients’ Survival Rate Post-transplantation Due To The Liver Quality Of DCD Donors

Objective:Donation after cardiac death(DCD) is an important donor supply in order to alleviate the shortage of liver donors, it has been already recognized by the World Health Organization and developed throughout the world. The aim of this study is to relate the liver quality of DCD donors with recipients’survival rate post-transplantation. Then we retrospectively analyze whether the risk factors contributing to the incidence of primary non-function,biliary complications,renal dysfunction.Methods:We retrospectively analyzed 185 cases of DCD liver transplantation in the First Affiliated Hospital of Zhejiang University from October 2010 to October 2014.Then it was divided into two groups according to the survival state:the death group (n= 31) and the survival group (n= 154), each group we collected DCD donors’age, gender, height, weight, body mass index (BMI), ALB, ALT,AST,TB,PT,warm ischemia time,cold ischemia time,cold preservation solution,the weight of donor liver, intraoperative blood loss, vascular active drug use, HBsAg, ABO blood type,biopsy of liver donors and so on. All the cases followed up at least one year.Results:The one-year mortality of DCD liver transplantation is 16.8%.16 recipients died of tumor recurrence,7 recipients died of MODS,3 recipients died of cardiovascular complications,2 recipients died of liver function failure,2 recipients died of sepsis,1 recipients died of neurological complications. Univariate analysis demonstrated that the recipients’survival rate of DCD liver transplantation associated with donors’ALB, total bilirubin, cold ischemia time, intraoperative blood loss, fatty liver,liver cell edema(P<0.05).Multivariate analysis showed that total bilirubin,cold ischemia time,fatty liver were the independent risk factors(P<0.05) of the recipients’survival rate of DCD liver transplantation. Cold ischemia time above 840 min, moderate or severe fatty liver contributed to primary non-function, biliary complications,renal dysfunction post-transplantation. Total bilirubin above 34.2μmol/L contributed to primary non-function,renal dysfunction post-transplantation.Conclusion:The one-year survival rate of the recipients after DCD liver transplantation is 83.2%.Total bilirubin,cold ischemia time,fatty liver are the independent risk factors of the recipients’ survival rate of DCD liver transplantation. Cold ischemia time above 840 min, moderate or severe fatty liver contribute to primary non-function,biliary complications,renal dysfunction post-transplantation. Total bilirubin above34.2μmol/L contributes to primary non-function,renal dysfunction post-transplantation.