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Early Outcomes for Liver Transplant with Thoracoabdominal Normothermic Regional Perfusion for Donation After Circulatory Death: A Multi-Center Experience

A. L. Brubaker1, A. Lee1, B. Jackson1, J. Berumen1, J. R. Parekh1, K. L. Mekeel1, A. R. Gupta2, J. M. Gardner2, T. Chaly3, A. K. Mathur4, C. Jadlowiec4, K. Reddy4, R. Nunez4, J. Bellingham5, E. Thomas6, J. R. Wellen7, M. Kearns1, V. Pretorius1, G. T. Schnickel1

1UC San Diego, San Diego, CA, 2UC San Francisco, San Francisco, CA, 3Arizona Transplant Associates, Phoenix, AZ, 4Mayo Clinic Arizona, Phoenix, AZ, 5California Pacific Medical Center, Orinda, CA, 6University of Texas, San Antonio, TX, 7Washington University, Saint Louis, MO

Meeting: 2022 American Transplant Congress

Abstract number: 132

Keywords: Donors, non-heart-beating, Liver transplantation, Outcome, Warm ischemia

Topic: Clinical Science » Liver » 57 - Liver: Surgery Innovative Techniques*

Session Information

Session Name: Surgery innovative Techniques Including Living Donor

Session Type: Rapid Fire Oral Abstract

Date: Sunday, June 5, 2022

Session Time: 5:30pm-7:00pm

 Presentation Time: 5:40pm-5:50pm

Location: Hynes Room 313

*Purpose: We evaluated early outcomes of liver transplant after thoracoabdominal normothermic regional perfusion (TA-NRP) for controlled donation after circulatory death (cDCD) donors.

*Methods: We identified liver allografts transplanted from cDCD donors after TA-NRP. Functional warm ischemic time (fWIT) was defined as systolic blood pressure <80 and/or oxygen saturation <80% until on TA-NRP bypass. Donor data included demographics, fWIT, total warm ischemia time (tWIT) and total time on TA-NRP. Recipient data included demographics, model of end stage liver disease (MELD), etiology of liver disease, primary graft non-function (PNF), cold ischemic time (CIT), laboratory markers of liver function, ICU and hospital length of stay (LOS), post-operative transplant related complications.

*Results: Eleven liver allografts from TA-NRP cDCD donors were included. The donors’ median age was 32, median BMI was 27.4, and they had no significant medical co-morbidities. Average fWIT was 22 minutes; fWIT exceeded 30 minutes in 2 donors. Median time on TA-NRP was 60 minutes. The median recipient listed MELD and MELD at transplant were 24 and 21, respectively. Average allograft CIT was 296 minutes (4.9 hours). Median peak liver function tests were AST 945 U/L, ALT 707 U/L, and lactate 2.0. There was no graft PNF. The median ICU and hospital LOS were 2 and 7 days, respectively. Two patients required management of biliary strictures after the index admission. Median follow up was 83 days. To date, no patient have required re-transplantation.

*Conclusions: Liver allografts from TA-NRP cDCD donors demonstrated reassuring early allograft and patient outcomes. Creating standardized guidelines and a data registry early in our TA-NRP experience will help our transplant community better optimize and utilize liver allografts from cDCD donors after TA-NRP.

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To cite this abstract in AMA style:

Brubaker AL, Lee A, Jackson B, Berumen J, Parekh JR, Mekeel KL, Gupta AR, Gardner JM, Chaly T, Mathur AK, Jadlowiec C, Reddy K, Nunez R, Bellingham J, Thomas E, Wellen JR, Kearns M, Pretorius V, Schnickel GT. Early Outcomes for Liver Transplant with Thoracoabdominal Normothermic Regional Perfusion for Donation After Circulatory Death: A Multi-Center Experience [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/early-outcomes-for-liver-transplant-with-thoracoabdominal-normothermic-regional-perfusion-for-donation-after-circulatory-death-a-multi-center-experience/. Accessed May 28, 2025.

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