Publication: Complicaciones biliares en trasplante hepático mediante la utilización de injertos procedentes de donantes con muerte circulatoria no controlada
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2021-07-09
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Universidad Complutense de Madrid
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Abstract
La donación después de la muerte encefálica (DME) representa la fuente más importante de injertos para trasplante hepático (TH). Para aumentar el número de injertos hepáticos se ha propuesto ampliar los criterios del donante, utilizando donantes marginales o donantes con criterios extendidos de la DME, el uso de hígados de donantes después de la muerte circulatoria controlada (DMCc, o tipo 3) o, con menos frecuencia, el uso de hígados de la donación de muerte circulatoria no controlada (DMCnc o tipo 2), motivo del presente estudio.
El talón de Aquiles del uso de hígados de donantes de DMCnc y DMCc es la mayor incidencia de complicaciones biliares (CB) en comparación con el uso de hígados de DME, siendo sobre todo específicas las estenosis biliares isquémicas no anastomóticas (EBNA) ocasionadas por la colangiopatía isquémica (CI) asociada al proceso de donación...
Donation after brain death (DBD) represents the most important source of grafts for liver transplantation (LT). In order to increase the number of liver grafts, it has been proposed to extend the donor criteria, using marginal donors or donors with extended criteria for DBD; and the use of donor livers after controlled circulatory death (cDCD), type 3 or, less frequently, the use of uncontrolled circulatory death donation livers (uDCD or type 2), reason for the present study. The Achilles' heel of the use of livers of uDCD and cDCD is the highest incidence of biliary complications (BC) compared to the use of livers of DBD, especially non-anastomotic ischemic biliary strictures (NABS) caused by the ischemic cholangiopathy (IC) associated with the donation process...
Donation after brain death (DBD) represents the most important source of grafts for liver transplantation (LT). In order to increase the number of liver grafts, it has been proposed to extend the donor criteria, using marginal donors or donors with extended criteria for DBD; and the use of donor livers after controlled circulatory death (cDCD), type 3 or, less frequently, the use of uncontrolled circulatory death donation livers (uDCD or type 2), reason for the present study. The Achilles' heel of the use of livers of uDCD and cDCD is the highest incidence of biliary complications (BC) compared to the use of livers of DBD, especially non-anastomotic ischemic biliary strictures (NABS) caused by the ischemic cholangiopathy (IC) associated with the donation process...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 09/02/2021