ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 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
    • 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
  • Advanced Search

Role of Donor Hemodynamic Trajectory in Determining Graft Survival in Liver Transplantation from Donation After Circulatory Death Donors.

D. Firl, K. Hashimoto, C. O'Rourke, J. Fung, B. Eghtesad.

Cleveland Clinic, Cleveland.

Meeting: 2016 American Transplant Congress

Abstract number: B248

Keywords: Cadaveric organs, Donors, Hemodynamics, Liver transplantation, non-heart-beating

Session Information

Date: Sunday, June 12, 2016

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

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

Related Abstracts
  • Donor Hemodynamic Profile Presages Graft Survival in Donation After Cardiac Death Liver Transplantation
  • Effect of Modifying Life Support Withdrawal Practices on Outcomes of Donation After Circulatory Death in Liver Transplantation: A Meta-Analysis.

This retrospective study of 87 donation after circulatory death (DCD) liver transplants from 2007-2015 tested the hypothesis that donor hemodynamic trajectory following withdrawal effects graft survival, distinctly from donor warm time. The donor shortage increases waiting list morbidity and mortality and despite their controversial application, the only short term solution is extended criteria donors, including DCD. We collected donor and recipient records from UNOS' Donornet and our prospectively collected transplant database, respectively. There was a high degree of heterogeneity of donor course across, withdrawal time, mean arterial pressure (MAP), oxygen saturation (SPO2), and pulse. Clustering analysis on MAP, SPO2, and pulse was used to explore the hemodynamics data. Combining clinical judgment with that pilot, we identified 3 distinct donor phenotypes; rapid decliners (C3, n=49), donors with long withdrawal and poor hemodynamics (C1, n=24), and donors with long withdrawal and nearer-physiologic hemodynamics (C2; n=14). Overall, results were acceptable and similar to other reports; 5-year graft survival of 72.1%. 1-, 3-, and 5-year graft survivals for MAP defined, C3 were 91.3%, 86.4%, and 71.7%. 1-, 3-, and 5-year graft survivals for MAP defined, C1, and C2 was 73.5%, 62.0%, and 62.0%, compared with 100.0%, 90.9%, and 90.9%, respectively (p=0.090). Donors across MAP cluster had similar, admission length prior to procurement, vasopressor support, CIT, LDRI, RWIT, laboratory MELD, recipient age and were transplanted in a similar era. C2 donors were younger than C3 and C1 (p=0.029). However graft survival was not associated with donor age (HR=1.00 per year; p=0.884). To test the hypothesis that C2 donors were equivalent to C3 and together, superior to C1, they were combined and compared to C1. Graft survival was clinically and statistically superior for MAP (p=0.038) but not SPO2 (p=0.232) defined C3+C2 clusters. In conclusion, the donor pool can be safely expanded through increased acceptance of livers from donors with extended withdrawal times but who maintain nearer-physiologic perfusion pressures during withdrawal.

CITATION INFORMATION: Firl D, Hashimoto K, O'Rourke C, Fung J, Eghtesad B. Role of Donor Hemodynamic Trajectory in Determining Graft Survival in Liver Transplantation from Donation After Circulatory Death Donors. Am J Transplant. 2016;16 (suppl 3).

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Firl D, Hashimoto K, O'Rourke C, Fung J, Eghtesad B. Role of Donor Hemodynamic Trajectory in Determining Graft Survival in Liver Transplantation from Donation After Circulatory Death Donors. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/role-of-donor-hemodynamic-trajectory-in-determining-graft-survival-in-liver-transplantation-from-donation-after-circulatory-death-donors/. Accessed March 4, 2021.

« Back to 2016 American Transplant Congress

Most Viewed Abstracts

  • This Week
  • This Month
  • All Time
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Penis Transplantation: First U.S. Experience.
  • Kidney Dialysis after Heart Transplantation: The Short and Long Term Outcomes
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Penis Transplantation: First U.S. Experience.
  • A Decade of Donor-Derived Disease: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC).
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Penis Transplantation: First U.S. Experience.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Evidence of a Clinically Significant Drug-Drug Interaction between Cannabidiol and Tacrolimus: A Case Report
  • Kidney Dialysis after Heart Transplantation: The Short and Long Term Outcomes

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 © 2013-2021 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.