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

Utilization of Older Donor after Cardiac Death Allografts in Liver Transplantation: An Opportunity to Increase the Donor Pool

F. Paterno, K. Wima, T. Diwan, M. Cuffy, N. Anwar, E. Woodle, S. Shah.

Surgery, University of Cincinnati, Cincinnati, OH.

Meeting: 2018 American Transplant Congress

Abstract number: A296

Keywords: Donors, Liver transplantation, marginal, non-heart-beating

Session Information

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

Session Type: Poster Session

Date: Saturday, June 2, 2018

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Hall 4EF

Background

Donors after cardiac death (DCD) liver allografts have been underutilized in liver transplantation especially in case of old donor age due to concerns of worse outcomes. The aim of this study is to assess recent national outcomes with DCD donors older than 40 years and evaluate the impact of donor and recipient characteristics on graft survival.

Methods

The Scientific Registry of Transplant Recipients database was queried for adult liver transplants from DCD donors older than 40 years performed between 2009 and 2015. DCD donors were classified in 2 subgroups: donor age between 40 and 50 years, donor age older than 50 years. A multivariable Cox regression model was used to assess effects of donor, recipient, and center characteristics on graft survival.

Results

Between 2009 and 2015, 2139 patients underwent liver transplants with DCD allografts, of which 720 (33.7%) from donors older than 40 years. Only 13% of all DCD donors were older than 50 years, while during the same time period the percentage of brain dead donors older than 50 years was significantly higher (35.7%, p<0.01).

One- and 5- year graft survival rates after liver transplant from DCD donors older than 40 years were 83.1% and 66.1%. In the multivariable Cox regression model, risk factors associated with graft loss were cold ischemic time (CIT) longer than 8 hours (hazard ratio, HR: 1.94, 95%CI: 1.37-2.75, p<0.01), recipient in intensive care unit at time of transplant (HR: 2.40, 95%CI: 1.27-4.51, p<0.01), and low transplant center volume (HR:1.56, 95%CI: 1.13-2.16, p<0.01). A CIT < 8 hours was associated with higher 1-, 3-, and 5-year graft survival rates when compared to CIT > 8 hours (85.3%, 75.9%, 68.6% versus 68.8%, 59.4%, 51.2% respectively, p<0.01). Donor warm ischemic time, defined as time from donor extubation to aortic cannulation (median: 22 minutes, interquartile range: 18-26 minutes) was not associated with graft survival. Moreover, there was no difference in graft survival between DCD donors older than 50 years and DCD donors between 40 and 50 years of age.

Conclusion

A CIT less than 8 hours is desirable to achieve better graft survival especially in DCD donors older than 40 years. Adequate patient selection and center expertise are also associated with better DCD outcomes. Selected DCD donors older than 50 years may achieve graft survival rates similar to donors of 40-50 years of age and can be used to expand the donor pool.

CITATION INFORMATION: Paterno F., Wima K., Diwan T., Cuffy M., Anwar N., Woodle E., Shah S. Utilization of Older Donor after Cardiac Death Allografts in Liver Transplantation: An Opportunity to Increase the Donor Pool Am J Transplant. 2017;17 (suppl 3).

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

To cite this abstract in AMA style:

Paterno F, Wima K, Diwan T, Cuffy M, Anwar N, Woodle E, Shah S. Utilization of Older Donor after Cardiac Death Allografts in Liver Transplantation: An Opportunity to Increase the Donor Pool [abstract]. https://atcmeetingabstracts.com/abstract/utilization-of-older-donor-after-cardiac-death-allografts-in-liver-transplantation-an-opportunity-to-increase-the-donor-pool/. Accessed June 6, 2025.

« Back to 2018 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