ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Center and Surgeons' Experience Improves Outcome in Adult-to-Adult Living Donor Liver Transplantation: Validation of the Report of the A2ALL Consortium.

S. Nagai, A. Yoshida, M. Rizzari, K. Collins, D. Kim, M. Abouljoud.

Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI.

Meeting: 2016 American Transplant Congress

Abstract number: A221

Keywords: Bile duct, Graft survival, Living-related liver donors, Risk factors

Session Information

Session Name: Poster Session A: Living Donor Liver Transplantation

Session Type: Poster Session

Date: Saturday, June 11, 2016

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Halls C&D

Background: Adult-to-adult living donor liver transplantation cohort study (A2ALL) has reported improved outcomes in centers with greater experience (>20 cases). The aim of this study was to validate and investigate the influence of center's and surgeons' experience by reviewing living donor liver transplantation (LDLT) outcomes in non-A2ALL single center.

Methods: LDLT from December 2000 to March 2015 was reviewed (n=90). Risk factor analysis for graft survival and postoperative biliary complications (leak [BL] and anastomotic stricture [BAS]) were conducted. Surgeons' and center's experience were included in potential factors. Surgeons A, B and C performed 75 (between center's case #1-89, 2000-2015), 8 (between case#15-25, 2005-2006), and 7 LDLTs (between case #73-90, 2011-2015), respectively.

Results: Graft survival in the center's first 20 cases was significantly worse (P=0.01, hazard ratio [HR]=3.57). Surgeon A's first 20 cases (early experience) was considered to be a risk factor of worse graft survival (P=0.01, HR=4.02 [Ref. Surgeon A's late experience]), but not surgeons B's and C's early experience (P=0.16 and 0.99, respectively). BL and BAS rates were 24% (22/90) and 19% (17/90). Surgeons A's and C's early experience remained independent risk factors for BL (P=0.01 and 0.02, odds ratio [OR]=3.96 and 7.67, respectively), along with recipient age (P=0.01, OR=1.06 per year) on multivariate analysis. Surgeon B's early experience increased a risk of BL, but not significant (P=0.27, OR=2.88). Type of biliary reconstruction (duct-to-duct vs. Roux-en-Y) or the number of ducts reconstructed was not a risk factor for BL. Center's or each surgeon's experience was not associated with BAS and no significant risk factors were identified.

Conclusion: Once center experience reached 20 LDLTs, early experience of new surgeons no longer affected graft survival. However, regardless of center's experience, BL was consistently associated with surgeons' early experience. Surgeon's technical experience may play an important role in complex biliary reconstructions.

CITATION INFORMATION: Nagai S, Yoshida A, Rizzari M, Collins K, Kim D, Abouljoud M. Center and Surgeons' Experience Improves Outcome in Adult-to-Adult Living Donor Liver Transplantation: Validation of the Report of the A2ALL Consortium. Am J Transplant. 2016;16 (suppl 3).

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Nagai S, Yoshida A, Rizzari M, Collins K, Kim D, Abouljoud M. Center and Surgeons' Experience Improves Outcome in Adult-to-Adult Living Donor Liver Transplantation: Validation of the Report of the A2ALL Consortium. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/center-and-surgeons-experience-improves-outcome-in-adult-to-adult-living-donor-liver-transplantation-validation-of-the-report-of-the-a2all-consortium/. Accessed May 8, 2025.

« Back to 2016 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences