Although good results have been reported with the use of normothermic regional perfusion (NRP) in controlled donation after circulatory death (cDCD) liver transplantation (LT), there is a lack of evidence to demonstrate similar results to donation after brain death (DBD). We present a single-center retrospective case-matched (1:2) study including 100 NRP cDCD LTs and 200 DBD LTs and a median follow-up of 36 months. Matching was done according to donor age, recipient Model for End-Stage Liver Disease score, and cold ischemia time. The following perioperative results were similar in both groups: alanine transaminase peaks of 909 U/L in the DBD group and 836 U/L in the cDCD group and early allograft disfunction percentages of 21% and 19.2%, respectively. The 1-year and 3-year overall graft survival for cDCD was 99% and 93%, respectively, versus 92% and 87%, respectively, for DBD (P = 0.04). Of note, no cases of primary nonfunction or ischemic-type biliary lesion were observed among the cDCD grafts. Our results confirm that NRP cDCD LT meets the same outcomes as those obtained with DBD LT and provides evidence to support the idea that cDCD donors per se should no longer be considered as “marginal donors” when recovered with NRP.

中文翻译：

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常温区域灌注循环死亡供体受控供肝与脑死亡供体肝移植的相似结果：病例匹配单中心研究

尽管在循环死亡 (cDCD) 肝移植 (LT) 后控制捐献中使用常温区域灌注 (NRP) 取得了良好的效果，但缺乏证据证明与脑死亡 (DBD) 后捐献的结果相似。我们提出了一项单中心回顾性病例匹配 (1:2) 研究，包括 100 个 NRP cDCD LT 和 200 个 DBD LT，中位随访时间为 36 个月。根据供体年龄、受体终末期肝病模型评分和冷缺血时间进行匹配。两组的以下围手术期结果相似：DBD 组丙氨酸转氨酶峰值为 909 U/L，cDCD 组为 836 U/L，早期同种异体移植物功能障碍百分比分别为 21% 和 19.2%。cDCD 的 1 年和 3 年总体移植物存活率分别为 99% 和 93%，P = 0.04）。值得注意的是，在 cDCD 移植物中未观察到原发性无功能或缺血型胆道病变的病例。我们的结果证实，NRP cDCD LT 与使用 DBD LT 获得的结果相同，并提供证据支持这样的观点，即当使用 NRP 恢复时，cDCD 捐献者本身不应再被视为“边际捐献者”。