Transplanting whole livers from donors less than 6 kilograms - Is it prudent?

N. Thao T. Nguyen, Theresa R. Harring, Hao Liu, John A. Goss, Christine A. O'Mahony

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Introduction: Experience suggests transplanting whole liver allografts (WL) from donors weighing <6 kg portends a worse prognosis. Patient and allograft survivals of infants who underwent transplantation with livers from donors ≥6 kg, <6 kg, or technical variant allografts from deceased donors (TV) and those from living donors (LD) were compared. Methods: The United Network of Organ Sharing database was queried for infant orthotopic liver transplantation (≤2 y). Of 5976 orthotopic liver transplantations, 860 patients received TV from deceased donors, 534 received LD split allografts, 509 patients had WL from donors weighing <6 kg, and 4073 remaining patients had WL from donors weighing ≥6 kg. Kaplan-Meier method and log-rank tests were employed. Results: Patients who received WL from donors weighing <6 kg had survival mean of 13.9 y ± 177 d. Overall patient survivals were 76.7%, 71.4%, 68.4%, and 65.9% at 1, 3, 5, and 10 y. This is significantly worse compared with all other groups, both in patient and allograft survival (P ≤ 0.001). In patients whose donors ≥6 kg, overall patient survivals were 82.1%, 78.7%, 77.3%, and 75.4% at 1, 3, 5, and 10 y. Infants who received TV had patient survival of 87.8%, 84.7%, 82.7%, and 80.6% at 1, 3, 5, and 10 y. Infants who received LD allografts had patient survival of 92.4%, 90.7%, 89.6%, and 88.5% at 1, 3, 5, and 10 y. Conclusions: Smaller weight of the donor influences the infant patient outcome. Patients with allografts from donors weighing <6 kg have a worse prognosis compared with those who received TV and LD allografts and those whose donors weigh ≥6 kg. Patients who receive LD allografts had the best survival.

Original languageEnglish (US)
Pages (from-to)348-358
Number of pages11
JournalJournal of Surgical Research
Volume177
Issue number2
DOIs
StatePublished - Oct 1 2012

    Fingerprint

Keywords

  • Allograft allocation
  • Cox regression
  • Donor weight
  • Liver transplantation
  • Pediatric
  • Split liver transplantation
  • Survival outcomes

ASJC Scopus subject areas

  • Surgery

Cite this