Utilisation of declined liver grafts yields comparable transplant outcomes and previous decline should not be a deterrent to graft use

Transplantation
Francesca MarconThamara Perera

Abstract

In the United Kingdom, up to 20% of liver graft offers are not utilized for transplantation and the reasons for graft refusal are multi-factorial and not consistent amongst transplant units. Liver grafts previously declined by other transplant centers in UK but transplanted in our unit in Birmingham between 2011 and 2015 were analyzed. According to the indicated reason for previous declines, liver grafts were categorized into 3 refusal groups: "quality", "logistics" and "other reasons". Results were compared to a matched, low risk cohort of livers primarily accepted and transplanted at our center. During the study period, 206 livers (DBD: n=141 (68.4%); DCD: n=65 (31.6%) were transplanted, which were previously discarded by a median of 4 other UK centres. The majority of declines were donor quality (n=102; 49.5%) refusals followed by logistics (n=45; 21.8%) and other reasons (n=59; 28.6%). Transplantation from both graft types (DBD and DCD) and all 3 refusal groups achieved equally good outcomes with an overall low complication rate. The incidence of primary-non-function (PNF, 2.4%vs.1.7%; p=0.5483), in-hospital mortality (6.3%vs.4.1%; p=0.2293) and 3-year graft (82.5% vs. 84.1%; p=0.6872)- and patient (85.4%vs.87.6%; p=0.8623)...Continue Reading

References

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Citations

Nov 15, 2018·International Journal of Molecular Sciences·Andrea Schlegel, Philipp Dutkowski
Jun 8, 2019·Expert Review of Gastroenterology & Hepatology·Marit KalisvaartAndrea Schlegel
Aug 31, 2020·World Journal of Transplantation·Yuhki SakuraokaAndrea Schlegel
Sep 17, 2020·Transplant International : Official Journal of the European Society for Organ Transplantation·James Neuberger, Chris Callaghan

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