Graft and Patient Survival in Liver Transplantation for Primary Sclerosing Cholangitis with Organs from DCD versus DBD Donors: Analysis of the UNOS Database.
1Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL
2Transplant, Mayo Clinic, Jacksonville, FL
Meeting: 2017 American Transplant Congress
Abstract number: C192
Keywords: Donors, Liver, non-heart-beating, Primary sclerosing cholangitis, Survival
Session Information
Session Name: Poster Session C: Organ Allocation, Meld Score, Organ Utilization, and Transplant Outcomes
Session Type: Poster Session
Date: Monday, May 1, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background: Primary sclerosing cholangitis (PSC) remains a major indication for liver transplantation (LT) worldwide. In an era of limited organ donation pool, assessment of PSC patients' survival and recurrence of disease following LT is important to help predict and improve outcomes and guide the process of organ selection. Donation after cardiac death (DCD) in this population remains controversial.
Objectives: To evaluate survival of patients undergoing liver transplantation for PSC. DCD vs. donation after brain death (DBD) will be assessed.
Methods: We examined the United Network For Organ Sharing (UNOS) database and identified patients with PSC who underwent LT between Jan 1, 1988 and Oct 31, 2016. Adult PSC patients were included. Kaplan-Meier survival analysis and log-rank tests were performed.
Results: 146,430 underwent LT in the UNOS database. PSC was the LT indication in 7804 (5%) patients. Mean age 45 years (SD±14.1), mean BMI 25 (SD± 4.8), 68% were males, 82% were white.
1041 PSC patients had data available on recurrence, and 28.7% (299) of them had PSC recurrence.
89.9% of PSC patients underwent deceased donor LT (DDLT) compared to 10.1% (620) who underwent living donor LT. DCD in PSC patients was less common than DBD (1.8% (N = 143) vs. 98.2% (N = 7661)).
The estimated patient survival probabilities of 5, 10, 15 and 20-years were 82.5%, 72.4%, 60.7% and 46.8%, respectively. No graft survival differences were noticed among those who received DCD vs. DBD. 
Conclusions: The majority of PSC patients received DDLT with DBD grafts. About one third had PSC recurrence. There was no significant difference in patient or graft survival in those receiving organs from DCD versus DBD grafts in the UNOS data base. This data, while preliminary suggests that patients awaiting transplant for PSC should be considered for DCD grafts. Further studies are warranted.
CITATION INFORMATION: Mousa O, Corral J, Pang M, Lee D, Nguyen J, Croome K, Harnois D. Graft and Patient Survival in Liver Transplantation for Primary Sclerosing Cholangitis with Organs from DCD versus DBD Donors: Analysis of the UNOS Database. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Mousa O, Corral J, Pang M, Lee D, Nguyen J, Croome K, Harnois D. Graft and Patient Survival in Liver Transplantation for Primary Sclerosing Cholangitis with Organs from DCD versus DBD Donors: Analysis of the UNOS Database. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/graft-and-patient-survival-in-liver-transplantation-for-primary-sclerosing-cholangitis-with-organs-from-dcd-versus-dbd-donors-analysis-of-the-unos-database/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress