Liver Allografts From Older Donors With or Without Recovery of Thoracic Organs and Their Impact on Hepatic Graft and Patient Survival

Objectives: Multiorgan procurement involving thoracic organs prolongs the liver recovery cross-clamp time. This may impact the outcome of hepatic allograft, more so in older donors (age > 60 years). We compared the outcomes of liver allografts from older donors with and without recovery of thoracic organs.

Materials and Methods: Using the Scientific Registry of Transplant Recipients database, we compared survival outcomes of 258 adults who received a liver allograft from older donors with thoracic organ recovery (group A) with 6006 patients who received liver allografts from older donor without thoracic organ recovery (group B). Furthermore, we performed a subgroup analysis matched for recipient and donor risk factors including presence of hypertension, diabetes mellitus, renal function, donor age, and use of inotropes. For the final analyses, there were 159 patients in group A and 468 in group B.

Results: The 1-month, 1-year, 3-year, and 5-year patient survival rates in group A were 95%, 91.6%, 70.1%, and 65.5% compared with 95%, 92%, 70%, and 57.7% in group B, respectively (P = .695). Graft survival rates for group A at the same time points were 91.5%, 81.0%, 71.7%, and 57.4% compared with 91.3%, 81.1%, 61.9%, and 50.4% in group B, respectively (P = .791). In the matched population, patient survival rates at 1 month, 1 year, 3 years, and 5 years were 95%, 83.1%, 77.1%, and 68.8% compared with 94.4%, 81.6%, 72.2%, and 66.8% in group B, respectively (P = .69). Graft survival rates at the same time points were 88.7%, 76.8%, 71.5%, and 63.1% in group A and 90.0%, 77.5%, 70.4%, and 62.5% in group B, respectively (P = .956).

Conclusions: Liver procurement with or without recovery of thoracic organs from donors > 60 years old does not affect liver grafts and recipient outcomes in the short-term or long-term and should be encouraged.

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Work Title Liver Allografts From Older Donors With or Without Recovery of Thoracic Organs and Their Impact on Hepatic Graft and Patient Survival
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Open Access
Creators
  1. Ricci Kalayanamitra
  2. Ashton Brooks
  3. Sushrut Trakroo
  4. Zakiyah Kadry
  5. Ashokkumar Jain
Keyword
  1. Graft and patient survival posttransplant
  2. Multiorgan procurement
  3. Scientific Registry of Transplant Recipients
  4. United Network for Organ Sharing
License In Copyright (Rights Reserved)
Work Type Article
Publisher
  1. Experimental and Clinical Transplantation
Publication Date December 2020
Publisher Identifier (DOI)
  1. 10.6002/ect.2020.0246
Deposited August 23, 2021

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Version 1
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  • Created
  • Added Creator Ricci Kalayanamitra
  • Added Creator Ashton Brooks
  • Added Creator Sushrut Trakroo
  • Added Creator Ashokkumar Jain
  • Added older_donor_first_ECT-OA-06-20-0246__003_.pdf
  • Added Creator Zakiyah Kadry
  • Updated Creator Ashokkumar Jain
  • Updated Publication Date Show Changes
    Publication Date
    • 2020-12
  • Updated License Show Changes
    License
    • https://rightsstatements.org/page/InC/1.0/
  • Published
  • Updated