Complications After Orthotopic Liver Transplantation Using Donation After Citizen's Death Versus Standard Criteria Donors

Objective To investigate the incidence of complications after orthotopic liver transplantation using donation after citizen's death(DCD)versus the standard criteria donors(SCD).Methods A retrospective study was conducted to analysis the clinical data from 296 patients who underwent orthotopic liver transplantation in the Oriental Hospital of Xiamen University between Jan.2009 and Dec.2017.197 SCD and 99 DCD recipients were included in the propensity score matching logistic model.89 pairs were created after one-to-one propensity-matching.The liver function recovery,incidence of biliary complications,acute kidney injury(AKI),infection,acute rejection(ACR),vascular complications and the patient survival rates between two groups were compared.Results The liver function recovery in DCD patients was significantly slower than SCD patients.The incidence of EAD was 39.3%for DCD group and 17.9%for SCD group(P=0.002).The incidence of PNF in the two groups were 7.9%and 4.3%(P=0.193).The incidence of postoperative biliary complications was 19.1%for DCD group and 15.7%for SCD group(P=0.553).The incidence of AKI was 48.3%for DCD group and 32.6%for SCD group(P=0.031).The incidence of infection complications was 59.6%and 42.7%for DCD patients and SCD patients(P=0.025),respectively;the incidence of ACR were 25.8%and 13.5%in two groups(P=0.041).The incidence of vascular complications in the two groups were 8.9%and 5.6%(P=0.232).The 1,2,and 3 year survival rates of patients were 80%,73%,and 70%for DCD patients and 85%,78%,and 72%for SCD patients(P=0.673),respectively.Conclusion Compared with SCD patients,the incidence of EAD,AKI,ACR and infection of DCD patients increased,but the 3-year survival rate,incidence of PNF,biliary complications and vascular complications had no difference.