Analysis Of Public Health Service Increased Risk Donors Shows No Viral Transmission In Liver Transplant Recipients And Similar Graft / Patient Survival When Compared To Non-increased Risk Donors
Department of Surgery, The Dumont-UCLA Transplant Center, Los Angeles, CA
Meeting: 2019 American Transplant Congress
Abstract number: C291
Keywords: Hepatitis B, Hepatitis C, HIV virus, Liver transplantation
Session Information
Session Name: Poster Session C: Liver: MELD, Allocation and Donor Issues (DCD/ECD)
Session Type: Poster Session
Date: Monday, June 3, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Public Health Service increased risk donors (PHS-IRD) are underutilized in liver transplant (LT) due to concern for transmission of viral (HBV, HCV, and HIV) infection and worse outcomes when compared to non-increased donors (non-IRD). The objectives of this study were to evaluate the risk of HBV, HCV, HIV transmission in LT recipients receiving PHS-IRD as well as to compare survival in LT recipients receiving livers from PHS- IRD versus non-IRD.
*Methods: We retrospectively analyzed 448 consecutive LT recipients at a single center from 2014 to 2016. 103 LT recipients received livers from PHS IRD and 345 received livers from non-IRD. All PHS-IRD LT recipients underwent protocol DNA/RNA quantitative testing for HBV, HCV, and HIV before LT, and after LT at 1-month, 6-month, and 12-months.
*Results: IRD were noted to younger, more commonly died from anoxic brain injury and had significantly higher transaminases at time of organ procurement compared to non-IRD. There was no statistically significant difference in age and MELD score between recipients of PHS IRD and non-IRD. [Table]. No HBV, HCV and HIV viral transmission was noted at 1-month, 6-month, and 12-month follow-up among LT recipients receiving PHS-IRD. 1-year graft survival for LT recipients receiving liver from PHS-IRD was 86.4% versus 87.5% for LT recipients receiving liver from non-IRD [p=0.685]. 1-year patient survival for LT recipients receiving liver from PHS-IRD was 87.3% versus 88.3% for LT recipients receiving liver from non-IRD [p = 0.660].
*Conclusions: Our study demonstrates no HBV, HCV and HIV transmission in LT recipients receiving PHS-IRD. In addition, 1-year graft and patient survival is similar in LT recipients receiving liver from PHS IRD versus non-IRD. While this is a single-center study, it signifies the safe utilization of PHS-IRD for LT.
| Clinical Factors | Non-IRD (n=345) | IRD (n=103) | p-value |
| Donor age (years) | 37 (1-76) | 32 (2-72) | 0.036 |
| Anoxic brain injury as cause of death | 84 (24%) | 37 (36%) | 0.02 |
| Donor AST (U/L) | 35 (5-747) | 65 (30-344) | <0.001 |
| Donor ALT (U/L) | 29 (2-403) | 44 (8-859) | 0.002 |
| Recipient age (years) | 56 (1-78) | 58 (5-78) | 0.326 |
| Recipient MELD at transplant | 38 (7-44) | 39 (6-45) | 0.246 |
To cite this abstract in AMA style:
Amin A, Ito T, Ng D, McMillan R, DiNorcia J, Agopian V, Kaldas F, Yersiz H, Busuttil R, Farmer D. Analysis Of Public Health Service Increased Risk Donors Shows No Viral Transmission In Liver Transplant Recipients And Similar Graft / Patient Survival When Compared To Non-increased Risk Donors [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/analysis-of-public-health-service-increased-risk-donors-shows-no-viral-transmission-in-liver-transplant-recipients-and-similar-graft-patient-survival-when-compared-to-non-increased-risk-donors/. Accessed November 21, 2024.« Back to 2019 American Transplant Congress