Living Liver Donor Follow-Up: Fewer Than Half of Centers Meet Follow-Up Requirements in the US
JHU, Baltimore.
Meeting: 2018 American Transplant Congress
Abstract number: 387
Keywords: Donation, Liver transplantation, Risk factors
Session Information
Session Name: Concurrent Session: Regulatory Issues
Session Type: Concurrent Session
Date: Monday, June 4, 2018
Session Time: 4:30pm-6:00pm
Presentation Time: 4:54pm-5:06pm
Location: Room 2AB
OPTN/UNOS began requiring 1-year living donor follow-up (LDF) for living liver donors (LLDs) in 2014. Compliance with a similar policy for living kidney donors was low. Using national registry data, we evaluated the changes in LDF associated with the 2014 policy and identified risk factor for non-compliance.
METHODS: Using SRTR data on 1624 LLDs who donated 09/2010-09/2016, we compared complete/timely LDF form submissions before and after policy implementation. Hierarchal logistic regression was used to assess region-, center-, and donor-level characteristics associated with complete/timely form submissions within a difference-in-differences framework. Compliance was defined as both timely and complete if clinical and laboratory data submitted 60 days before or after the expected visit date as defined by OPTN/UNOS.
RESULTS: LDF form compliance increased between 9/2010-9/2016 (Figure 1). However, out of 43 transplant centers performing living liver donation 9/14-9/15, we found that only 13 (30%) centers had provided complete/timely data for 6- and 12-month LDF (Figure 2). Among non-compliant centers 9/14-9/15 (N=26), the median (range) number of visits that were missed but necessary to meet compliance thresholds was 4 (1-19) LDF visits. Policy implementation was not associated with change in 6-month LDF (p=0.3) or 12-month LDF (p=0.2). Characteristics associated with non-compliant 1-year LDF include younger donor age (p=0.03), lack of health insurance (p=0.03), and international donor status (p<0.001).
CONCLUSION: Though compliance is improving over time, fewer than half of transplant centers performing living liver donation are compliant with OPTN/UNOS requirements. Novel practices to engage living liver donors may be needed to improve LDF compliance.
CITATION INFORMATION: Thomas A., Holscher C., Shaffer A., Garonzik-Wang J., Massie A., Segev D., Henderson M. Living Liver Donor Follow-Up: Fewer Than Half of Centers Meet Follow-Up Requirements in the US Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Thomas A, Holscher C, Shaffer A, Garonzik-Wang J, Massie A, Segev D, Henderson M. Living Liver Donor Follow-Up: Fewer Than Half of Centers Meet Follow-Up Requirements in the US [abstract]. https://atcmeetingabstracts.com/abstract/living-liver-donor-follow-up-fewer-than-half-of-centers-meet-follow-up-requirements-in-the-us/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress