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PTU-064 The use of non-heart-beating donor grafts increases perioperative resource utilisation in liver transplantation
  1. R Broomhead1,
  2. S Patel1,
  3. A K Burroughs2,
  4. B S Fernando3,
  5. S Mallet2,
  6. J P O'Beirne2
  1. 1Department of Anaesthesia, Royal Free Hospital, London, UK
  2. 2The Sheila Sherlock Liver Centre, Royal Free Hospital, London, UK
  3. 3Department of HPB Surgery and Liver Transplantation, Royal Free Hospital, London, UK

Abstract

Introduction The use of NHBD donor grafts for liver transplantation (LT) is increasing. Large series suggest that patient outcomes are equivalent to heart beating donor (HBD) graft recipients but there is currently scarce literature on the impact on the increasing use of NHBD on perioperative resource utilisation.

Methods We analysed patients undergoing NHDB LT in our centre over a 2-year period and compared perioperative variables to a similar number of HBD recipients (matched for age, disease severity and indication) to determine if the use of NHBD donor livers increased resource utilisation.

Results 16 NHBD recipients were matched to 16 patients undergoing HBD LT. There were no differences in indication, MELD, age or sex between the groups. NHBD LT was associated with more frequent post reperfusion hypotension and clinically significant lysis requiring tranexamic acid. Post operative stay on ITU was longer and there was a more frequent need for vasopressors, ventilation and renal replacement therapy in NHBD recipients (Abstract 064). 2 patients (both from the NHBD group) had primary non-function and underwent emergency regrafting. 90-day survival was 100% in both groups.

Abstract PTU-064

Conclusion The use of NHBD grafts in LT results in acceptable patient and graft survival however there appears to be increased severity of reperfusion syndrome and more requirement for post operative organ support. These data suggest that though patient outcomes may not be significantly affected, increasing use of NHBD grafts may lead to significantly impact on the resources and costs associated with liver transplantation.

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