Impact of Donor Hepatectomy Time during Organ Procurement in Donation after Circulatory Death Liver Transplantation; The United Kingdom Experience
St James University Hospital, Leeds, United Kingdom.
Meeting: 2018 American Transplant Congress
Abstract number: 466
Keywords: Donors, Liver grafts, Liver transplantation, non-heart-beating, Procurement
Session Information
Session Name: Concurrent Session: Liver: MELD, Allocation and Donor Issues - 2
Session Type: Concurrent Session
Date: Tuesday, June 5, 2018
Session Time: 2:30pm-4:00pm
Presentation Time: 2:30pm-2:42pm
Location: Room 6B
Introduction
No data exists to evaluate the impact of hepatectomy time (HT) during donation after cardiac death (DCD) procurement on short and long-term outcomes following liver transplantation (LT). In this study we analyse the impact of the time from aortic perfusion to end of hepatectomy on outcomes following DCD LT across all UK transplant centers.
Methods
Using data requested from NHSBT, we identified 1112 adult patients receiving a first LT in the UK between 1 January 2001 and 31 August 2015 from a DCD donor. Primary end points were PNF and all cause graft survival. A cohort of DBD donor recipients (n=7221) in the same time period was included to allow comparison of long-term survival. Statistical methods included logistic regression and cox proportional hazard models.
Results
Incidence of PNF was 40 (4%) and in multivariate analysis only CIT >8 hrs. (HZ 2.186 (1.113-4.294, p=0.023) and HT > 60 mins (HZ 3.669 (1.363-9.873, p=0.01) were correlated with PNF. Overall 90 day, 1 yr., 3 yr. and 5 yr. graft survival in DCD LT was 91.2%, 86.5%, 80.9% and 77.7% (compared to a DBD cohort in the same period (n=7221) 94%, 91%, 86.6%, and 82.6% respectively (p<0.001)). In multivariate analysis the factors associated with poorer graft survival were HT >60 mins (or more specifically, >53mins on a continuous spectrum), donor age >45 yrs., CIT> 8 hours and recipient previous abdominal surgery.
Discussion
The largest study to date to demonstrate a negative impact of prolonged HT on outcomes on DCD LT and although HT >53 mins is not a contraindication for utilisation it should be taken into a multifactorial assessment with established prognostic donor factors such as age (>45yrs) and CIT (>8hrs) for ana appropriately selected recipient.
CITATION INFORMATION: Farid S., Magdy A., Vijayanand D., Upasani V., Willis S., Barlow A., Ernest H., Niaz A. Impact of Donor Hepatectomy Time during Organ Procurement in Donation after Circulatory Death Liver Transplantation; The United Kingdom Experience Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Farid S, Magdy A, Vijayanand D, Upasani V, Willis S, Barlow A, Ernest H, Niaz A. Impact of Donor Hepatectomy Time during Organ Procurement in Donation after Circulatory Death Liver Transplantation; The United Kingdom Experience [abstract]. https://atcmeetingabstracts.com/abstract/impact-of-donor-hepatectomy-time-during-organ-procurement-in-donation-after-circulatory-death-liver-transplantation-the-united-kingdom-experience/. Accessed May 12, 2025.« Back to 2018 American Transplant Congress