Date: Tuesday, June 14, 2016
Session Time: 2:30pm-4:00pm
Presentation Time: 2:30pm-2:42pm
Location: Room 304
Liver transplantation benefits registrants with MELD≥18. However, this benefit no doubt varies by donor characteristics, and the benefit of DCD livers remains unclear.
Methods: We used Cox regression and SRTR data 2006-2015 to estimate mortality associated with DCD-LT among registrants without status-1/exception, adjusting for patient characteristics. We further calculated survival benefit of DCD-LT stratified by Donor Risk Index (DRI). Effect modification analysis identified MELD subgroups who benefit from DCD-LT. Additionally, we studied discard associated with DCD, using Poisson regression.
Results: Among 25,383 recipients, 1,269 (5%) received DCD-LT. DCD-LT conferred significantly lower mortality after 1m post-LT among low/medium-DRI livers, but not among high-DRI livers (Table1):
|All DCDs||DCDs, low DRI||DCDs, medium DRI||DCDs, high DRI|
Consequently, cumulative 5-year mortality was 375161% lower for DCD recipients with low DRI, 344758% lower for DCD recipients with medium DRI, and unchanged (-15726%) for DCD recipients with high DRI:
DCD benefit varied by MELD. (e.g. high DRI):
DCD-LT with low/medium/high DRI provided significant 5-years survival benefit for registrants with MELD≥18/21/25, respectively.
DCD had 2-3-fold higher discard risk than DBD with similar DRI (Table2):
|DBD||DCD||Adjusted discard risk (DCD vs DBD)|
Conclusions: DCD-LT provides long-term survival benefit, especially for registrants with MELD≥25. Lower DRI conferred greater benefit. Discard rates for DCD livers are very high, but some discarded DCD livers may provide significant survival benefit for some patients.
CITATION INFORMATION: Luo X, Massie A, Segev D. Survival Benefit of DCD Livers. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Luo X, Massie A, Segev D. Survival Benefit of DCD Livers. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/survival-benefit-of-dcd-livers/. Accessed March 3, 2021.
« Back to 2016 American Transplant Congress