Session Time: 4:30pm-6:00pm
Presentation Time: 4:54pm-5:06pm
Location: Room 304
Hepatocellular carcinoma (HCC) remains the most commonly granted MELD exception (M/E). Share 35 has disadvantaged this population. We have developed a strategy to use traditionally unacceptable organs (TUOs) including locally discarded organs, grafts with macrosteatosis, and DCD donors for these recipients.
A retrospective review of the patients transplanted for HCC in a large urban academic medical center was performed from 1/2012-8/2015. Recipient and Donor data were obtained from our databases. Longitudinal follow-up has been maintained for recurrence of HCC. M/E at transplant, time to transplant, donor origin and organ type were analyzed.
In 2012, 30% of patients were transplanted under an HCC M/E. They had an average waitlist time of 435 days and 85% of the grafts were from local donors. After Share 35, the HCC M/E patients made up only 20% of the transplanted population with most of livers (85%) procured locally. This decreased to 15% with concomitant increase in the time to transplant. In 2015, with the use of TUOs for the HCC population we observed an increase in the percentage of M/E (30%) patients transplanted with a decrease in transplant time (213 days v. 311days, p=0.001). Regionally procured livers increased to 50% for the HCC M/E population. There was no change in the average MELD at transplant in the time periods analyzed (p=0.2).
Liver transplantation in the Share 35 era disadvantages the HCC M/E population. An aggressive approach to the use of local and regional TUOs may increase in the number of M/E patients transplanted. This may lead to a reduction in waitlist time and a reduction in early disease recurrence.
|Year||N=Liver Transplant for HCC||Ave. MELD at Transplant (p=0.2)||Ave. Wait time (days) p=0.001)||Import Livers (%)|
CITATION INFORMATION: Siskind E, MacDonald T, Barth R, LaMattina J, Bruno D, Hanish S. Traditionally Unacceptable Organs Promote Liver Transplantation in Patients with Long Waiting Times in the Share 35 Era. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Siskind E, MacDonald T, Barth R, LaMattina J, Bruno D, Hanish S. Traditionally Unacceptable Organs Promote Liver Transplantation in Patients with Long Waiting Times in the Share 35 Era. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/traditionally-unacceptable-organs-promote-liver-transplantation-in-patients-with-long-waiting-times-in-the-share-35-era/. Accessed June 6, 2020.
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