Intr Low MELD patients have less access to liver transplantation (LT) and increasingly receive 'marginal' organs with risk of graft failure (GF). Despite increased utilization of marginal organs, there is a national trend towards improved graft/patient survival. Thus, previous estimates of donor characteristics associated with GF may no longer apply. Methds: We identified donor characteristics associated with GF at 1-year from 8721 patients who received a LT at MELD score≤25 using national data. Characteristics were compared between 2 eras; pre-Share35 (6/1/2010-5/31/2013) and post-Share35 (6/1/2013-6/2/2015) to assess for changes in donor characteristics over time. Results: pre-Share35 n=5463.Post-Share35 n= 3258. 1-year graft failure 5.0% pre-Share35 vs 5.3% post-Share35 (p=NS). Significant donor characteristics associated with graft failure pre-Share35/post-Share35.

Donor age 60-69 (pre-Share35 HR 1.65 vs post-Share35 HR 0.72 p=0.04), COD: anoxia (pre-Share35 HR 1.24 vs post-Share35 HR 0.61 p=0.03), and donor diabetes (pre-Share35 HR 1.03 vs post-Share35 HR 2.92 p=0.0008) were significantly different by era. Conclusion: Recent changes in the donor pool e.g. increased drug abuse deaths and willingness to use more marginal grafts is driving a change in donor characteristics associated with GF. This is supported by a trend towards decreasing recipient risk with donor COD:anoxia and donor age. Centers declining these grafts on the basis of previous risk factors should be cognizant of changes. However, centers should also be aware of the risk posed by donor diabetes.

CITATION INFORMATION: Atiemo K., Skaro A., Craig-Schapiro R., Montag S., VanWagner L., Abecassis M., Levitsky J., Zhao L., Ladner D. Are Deceased Donor Characteristics Associated with Liver Graft Failure among Low MELD Patients Receiving a Liver Transplant Changing Am J Transplant. 2017;17 (suppl 3).

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