en
Scientific article
Open access
English

The impact of perceived donor liver quality on post-transplant outcome

Published inANZ journal of surgery, vol. 93, no. 4, p. 918-925
Publication date2023-04
First online date2023-01-27
Abstract

Background: We analysed the impact of perceived liver donor quality on transplant recipient outcomes.

Methods: this prospective cohort study included all deceased liver donors during 2008-2018 in the Swiss Transplant Cohort Study. Perceived low-quality liver donors were defined when refused for ≥5 top listed recipients or for all recipients in at least one centre before being transplanted. The effect of liver donor quality on relisting or recipient death at 1 week and 1 year after transplantation was analysed using Kaplan-Meier and Cox proportional hazard models. A 1:3 matching was also performed using a recipient score.

Results: Of 973 liver donors, 187 (19.2%) had perceived poor-quality. Males, obesity, donation after circulatory death and alanine aminotransferase values were significantly associated with perceived poor-quality, with no significant effect of the perceived quality on re-listing or death within the first week and first year post-transplant [(aHR) = 1.45, 95% CI: (0.6, 3.5), P = 0.41 and aHR = 1.52 (95% CI 0.98-2.35), P = 0.06], adjusting by recipient age and gender, obesity, diabetes, prior liver transplantation and model for end-stage liver disease (MELD) score. At 1 year, prior liver transplantation and higher MELD score associated with higher risk of re-listing or death.

Conclusion: Comparable post-transplant outcomes with different perceived quality liver donors stresses the need to improve donor selection in liver transplantation.

eng
Keywords
  • Extended criteria donor
  • Liver allocation
  • Liver transplantation
  • Marginal donor
  • Cohort Studies
  • End Stage Liver Disease / surgery
  • Graft Survival
  • Humans
  • Liver Transplantation
  • Living Donors
  • Male
  • Obesity
  • Prospective Studies
  • Retrospective Studies
  • Severity of Illness Index
  • Tissue and Organ Procurement
Funding
  • Swiss National Science Foundation -
Citation (ISO format)
DIRCHWOLF, Melisa et al. The impact of perceived donor liver quality on post-transplant outcome. In: ANZ journal of surgery, 2023, vol. 93, n° 4, p. 918–925. doi: 10.1111/ans.18217
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Article (Published version)
Identifiers
ISSN of the journal1445-1433
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