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

Marginal Not So Marginal Anymore: Time for New Definitions for “Marginal” Allografts in Liver Transplantation?

T. Zhang1, J. Dunson1, F. Kanwal2, T. Galvan2, J. Vierling2, C. O'Mahony2, J. Goss2, A. Rana2

1Medical Student, Baylor College of Medicine, Houston, TX, 2Baylor College of Medicine, Houston, TX

Meeting: 2020 American Transplant Congress

Abstract number: D-115

Keywords: Donors, marginal, Liver transplantation

Session Information

Session Name: Poster Session D: Liver: MELD, Allocation and Donor Issues (DCD/ECD)

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: We examined time trends in the outcomes of patients who received marginal liver allografts defined on the basis of the Donor Risk Index [DRI] and five secondary definitions.

*Methods: 70,050 liver transplant recipients between 2002 and 2016 were retrospectively analyzed to last known follow up (n=55,395) or death (n=19,655) using the United Network for Organ Sharing. The study period was divided into three 5-year eras. We used Kaplan-Meier with log-rank test and Cox regression methods to examine the graft following transplantation with marginal allografts; latter defined as 90th percentile Donor Risk Index [DRI] and five secondary definitions.

*Results: DRI, patient Model for End-stage Liver Disease (MELD) scores, and balance of risk (BAR) scores significantly increased over time. Despite sicker recipients, multivariate Cox regression analysis indicates that 90th percentile DRI allograft survival increased across the study period (2002-2006 HR 1.41 (1.34 – 1.49); 2007-2011 HR 1.25 (1.17 – 1.34); and 2012-2016 HR 1.10 (0.98 – 1.24)). By the end of the study period, no significant difference in recipient survival between 90th percentile DRI allografts and benchmark allografts remained (77.7% vs. 80.3%), in part due to a significant decrease in cold ischemia time. Marginal allografts defined using secondary definitions showed similar improvements in graft survival and recipient survival.

*Conclusions: Our data encourages the aggressive use of liver allografts and may indicate a need for a redefinition of allograft marginality in liver transplantation.

 border=

Figure 1. 90th Percentile DRI Kaplan-Meier Allograft Survival Over Time. P-values were calculated based on Log Rank Test for Equality of Survivor Functions.

 border=

Figure 2. A) Deceased cardiac donor Kaplan-Meier allograft survival over time. B) National share Kaplan-Meier allograft survival over time. C) Donor age over 70 Kaplan-Meier Survival allograft over time. D) Fatty liver Kaplan-Meier allograft survival over time. E) 90th percentile DSRI Kaplan-Meier allograft survival over time. P-values were calculated based on Log Rank Test for Equality of Survivor Functions.

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Zhang T, Dunson J, Kanwal F, Galvan T, Vierling J, O'Mahony C, Goss J, Rana A. Marginal Not So Marginal Anymore: Time for New Definitions for “Marginal” Allografts in Liver Transplantation? [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/marginal-not-so-marginal-anymore-time-for-new-definitions-for-marginal-allografts-in-liver-transplantation/. Accessed May 11, 2025.

« Back to 2020 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