No difference in clinical transplant outcomes for local and imported liver allografts

Richard Mangus, Jonathan A. Fridell, Rodrigo M. Vianna, Paul Y. Kwo, Paul Chestovich, Martin L. Milgrom, Marwan Kazimi, Edward F. Hollinger, Jay Thomas Read, A. Joseph Tector

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

In the United States, liver allograft allocation is strictly regulated. Local centers have the first option to accept a donor liver; this is followed by regional allocation for those donor livers not used locally and then by national allocation for those donor livers not accepted regionally. This study reviews the outcomes of all liver allografts used over 6 years (2001-2007) and evaluates initial and long-term function stratified by the geographic source of the donor liver allograft. The records for 845 consecutive deceased donor liver transplants at a single center were reviewed. The geographic origin of the allograft was recorded along with donor and graft characteristics to determine the probable reason for graft refusal. Within our local organ procurement organization, there is 1 liver transplant center, and within the region, there are 8 active centers. Early graft failure included any graft loss within 7 days of transplant, and initial function was measured with liver enzymes 30 days post-transplant. Graft survival and patient survival were evaluated with Kaplan-Meier and Cox survival modeling. Median follow-up was 43 months. The geographic distribution of organs included local organs (562, 66%), regionally imported organs (126, 15%), and nationally imported organs (157, 19%). There were no differences between the 3 groups in initial graft function, intraoperative death, or early graft loss. Survival curves for the 3 study groups demonstrated no difference in survival up to 5 years post-transplant. In conclusion, liver allografts rejected for use by a large number of transplant centers can still be successfully used without early graft function or long-term survival being affected.

Original languageEnglish
Pages (from-to)640-647
Number of pages8
JournalLiver Transplantation
Volume15
Issue number6
DOIs
StatePublished - 2009

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Allografts
Transplants
Liver
Tissue Donors
Survival
Tissue and Organ Procurement
Graft Survival
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Surgery
  • Transplantation
  • Hepatology

Cite this

Mangus, R., Fridell, J. A., Vianna, R. M., Kwo, P. Y., Chestovich, P., Milgrom, M. L., ... Tector, A. J. (2009). No difference in clinical transplant outcomes for local and imported liver allografts. Liver Transplantation, 15(6), 640-647. https://doi.org/10.1002/lt.21726

No difference in clinical transplant outcomes for local and imported liver allografts. / Mangus, Richard; Fridell, Jonathan A.; Vianna, Rodrigo M.; Kwo, Paul Y.; Chestovich, Paul; Milgrom, Martin L.; Kazimi, Marwan; Hollinger, Edward F.; Read, Jay Thomas; Tector, A. Joseph.

In: Liver Transplantation, Vol. 15, No. 6, 2009, p. 640-647.

Research output: Contribution to journalArticle

Mangus, R, Fridell, JA, Vianna, RM, Kwo, PY, Chestovich, P, Milgrom, ML, Kazimi, M, Hollinger, EF, Read, JT & Tector, AJ 2009, 'No difference in clinical transplant outcomes for local and imported liver allografts', Liver Transplantation, vol. 15, no. 6, pp. 640-647. https://doi.org/10.1002/lt.21726
Mangus, Richard ; Fridell, Jonathan A. ; Vianna, Rodrigo M. ; Kwo, Paul Y. ; Chestovich, Paul ; Milgrom, Martin L. ; Kazimi, Marwan ; Hollinger, Edward F. ; Read, Jay Thomas ; Tector, A. Joseph. / No difference in clinical transplant outcomes for local and imported liver allografts. In: Liver Transplantation. 2009 ; Vol. 15, No. 6. pp. 640-647.
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