Miami Protocol for Liver Deceased Donors After Circulatory Death: Increased 1-year Overall Survival for Selected Patients
University of Miami, Jackson Memorial Hospital, Miami Transplant Institute, Miami, FL
Meeting: 2022 American Transplant Congress
Abstract number: 1437
Keywords: Donors, marginal, Donors, non-heart-beating, Organ Selection/Allocation, Survival
Topic: Clinical Science » Liver » 57 - Liver: Surgery Innovative Techniques*
Session Information
Session Name: Liver: Surgery Innovative Techniques*
Session Type: Poster Abstract
Date: Monday, June 6, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: The use of deceased donors after circulatory death (DCD) for liver transplantation (LT) is still underutilized. It provides an acceptable solution to increase the organ donor pool without affecting outcomes. We analyzed data of DCD donors for LT in order to identify risk factors for graft and patient survival.
*Methods: This was a retrospective cohort study using data reviewed by screening SRTR/UNOS of patients that underwent liver transplantation with DCD donor at Jackson Memorial Hospital in Miami, FL from 2017 to 2019. Different surrogates were analyzed, including donor, recipient, procurement and transplant operation characteristics. The primary outcome was patient and graft survival. Continuous variables were analyzed using a 2-sided student t-test. Categorical variables were presented as frequencies and proportion and compared using chi-squared or Fisher’s exact test as appropriate. Univariable Cox proportional hazards models were fit in order to assess the impact of individual covariables on the instantaneous rate of events, with time-to-event analysis also being ascertained through Kaplan-Meier estimates.
*Results: 54 cases were analyzed with a median MELD score of 18.5. Alcoholic cirrhosis was the most prevalent etiology for liver disease. The 1-year survival rate following liver transplant using DCD donors was 90.7% (Figure 1). The total cold ischemic time (CIT) (HR 1.9, 95% CI 1.1-3.2) and diagnosis of rejection (HR 9, 95% CI 1.1-78.8) were statistically significant affecting graft failure. Estimated blood loss (EBL) with HR of 1.1 (95% CI 1.1-1.2) was found to be statistically impacting survival rate.
*Conclusions: DCD donors are excellent options to increase the availability of organs for patients waiting for a LT. CIT and EBL are the main predictors or poor outcomes and thus should be carefully taken into account when matching organs to recipients.
To cite this abstract in AMA style:
Venkatasamy V, Abreu P, Riella J, Miyashiro R, Tector A, Tekin A, Selvaggi G, Vianna R. Miami Protocol for Liver Deceased Donors After Circulatory Death: Increased 1-year Overall Survival for Selected Patients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/miami-protocol-for-liver-deceased-donors-after-circulatory-death-increased-1-year-overall-survival-for-selected-patients/. Accessed November 23, 2024.« Back to 2022 American Transplant Congress