The Implication of Center Volumes in Donation After Circulatory Death for Liver Transplantation: Donor-Recipient Selection and Outcomes.
Transplant Proc
; 54(7): 1707-1710, 2022 Sep.
Article
em En
| MEDLINE
| ID: mdl-35871009
ABSTRACT
BACKGROUND:
The use of donation after circulatory death liver transplant (DCD LT) has increased and the outcomes have improved. There are little data concerning the details of centers' practice.METHODS:
Using the United Network for Organ Sharing Standard Transplant Analysis and Research data, the centers were stratified into 4 quartiles lowest-, low-, high-, and highest-volume quartiles.RESULTS:
High-risk donors, defined as older donors (≥50 years) or obese donors (body mass index ≥ 30 kg/m2), linearly increased in line with the centers' volumes (P < .001), while cold ischemia time (CIT) showed an inverse correlation (P < .001). High-risk recipients, defined as those with high Model for End-stage Liver Disease score, re-LT, inpatient, or ventilator/dialysis before LT, did not show any significant difference (P = .74) except in the highest-volume quartile (P < .001). One-year graft survival showed a bimodal pattern across the 4 quartiles (P = .027) superior graft survival in the highest-volume quartile and in the low-volume quartile and inferior graft survival in the high-volume quartile and in the lowest-volume quartile.CONCLUSIONS:
High-risk donors can achieve satisfactory outcomes by being matched with low-risk recipients and shortening CIT. However, high-risk recipients may not result in favorable outcomes with DCD LT even with centers' experience and shorter CIT.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Obtenção de Tecidos e Órgãos
/
Transplante de Fígado
/
Doença Hepática Terminal
Tipo de estudo:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Transplant Proc
Ano de publicação:
2022
Tipo de documento:
Article
País de publicação:
EEUU
/
ESTADOS UNIDOS
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ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
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UNITED STATES OF AMERICA
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US
/
USA