Date: Sunday, June 12, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: Demand for livers from deceased donors exceeds supply after Share 35 in June 2013. This leads liver transplant centers to consider high risk deceased donors (HRDDs) based on Centers for Disease Control and Prevention (CDC) criteria.
Objective: We sought to evaluate the effects of HRDDs on liver transplantation outcomes according to Share 35.
Methods: A total of 287 first time-liver transplant were done between June 2011 and June 2015 and retrospectively reviewed. Patients received multi-organ transplant other than liver/kidney were excluded (n=11). Recipients were examined based on pre and after-share 35, (N =276; 115 pre-era, 161 after-era). HRDDs were identified according to the OPTN policy in effect on the date of referral (n=52).
Results: The proportion of patients transplanted who received HRDDs increased from 9.6% (11/115) pre-share 35 to 25.5% (41/161) after-share 35 implementation, (P < 0.001). There were no significant differences between pre and after-share 35 regarding donor age (36 +/- 16) vs (35 +/- 13), cold ischemic time (6.5 +/- 2.1 hour) vs (6.3+/-2.3 hour), and donor risk index (1.3+/-0.3) vs (1.3+/-0.3) correspondingly (p=NS). However, warm ischemic time was significantly lower after-share 35 (26 +/- 7 minute) vs (31+/- 9 minute) compared to pre-share 35 (p=<0.001). Recipient biological MELD scores at OLT were significantly higher after-share35 (32+/- 13) vs (24 +/- 12) pre (p=<0.001). One and two year survivals were similar pre (94% and 90%) and after-share 35 era (92% and 88%).
Conclusions: Use of high risk deceased donors for liver transplantation is relatively safe. Share 35 was associated with more transplants, and comparable outcomes without increase in cold ischemic time cost. Utilization of HRDDs had no negative impact on patient outcomes.
CITATION INFORMATION: Boktour M, Saharia A, Victor D, Gordon-Burroughs S, Mobley C, McFadden R, Ankoma-Sey V, Galati J, Gaber A, Monsour H, Ghobrial R. Increased Utilization of High Risk Deceased Donors with Share 35 Does Not Affect Outcomes in Liver Transplantation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Boktour M, Saharia A, Victor D, Gordon-Burroughs S, Mobley C, McFadden R, Ankoma-Sey V, Galati J, Gaber A, Monsour H, Ghobrial R. Increased Utilization of High Risk Deceased Donors with Share 35 Does Not Affect Outcomes in Liver Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). http://atcmeetingabstracts.com/abstract/increased-utilization-of-high-risk-deceased-donors-with-share-35-does-not-affect-outcomes-in-liver-transplantation/. Accessed November 22, 2017.
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