*Purpose: In a prior study using national registry data, deceased donor age greater than 50 was associated with a 35% to 61% increased risk of hepatic artery thrombosis (HAT). There has been no contemporary evaluation of incident HAT in current landscape of deceased donor organ pool changes.

*Methods: We used SRTR data from 01/1990- 03/2019 to identify first-time adult deceased donor liver transplant recipients. We used cox regression to quantify the change in HAT incidence over time, adjusting for recipient age and sex. HAT was defined by graft failure or death due to vascular thrombosis within 90 days of transplant. We used linear regression to characterize changes in mean donor age over time.

*Results: We studied 109,797 liver transplant recipients. Between 1990 and 2005, the mean donor age increased yearly by 0.65 years (95% CI: 0.61-0.68). After 2005, mean donor age plateaued (Figure 1). Despite increasing donor age, the risk of HAT decreased significantly every 5 years during the study period (adjusted Hazard Ratio: 0.73, 95% CI: 0.72-0.74).

*Conclusions: The decline in HAT despite utilization of older donors likely reflects unmeasured factors that have allowed for more informed selection of deceased donor organs or improved donor-recipient matching.

Figure 1. HAT Events and Mean Donor Age over Time

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