American journal of surgery · 2025
Outcomes of liver transplants utilizing donors from outside the contiguous United States.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Jenkins Reed T, Hapuarachchy Binuri L, Shah Manuj M, Larson Emily L, Zhou Alice L, Farhat David J, Ruck Jessica M, Rached Helene, King Elizabeth A, Philosophe Benjamin, Kassam Al-Faraaz
Аннотация
PURPOSE: Expanding the liver donor pool includes reconsidering geographic characteristics. We evaluated demographics, trends, and outcomes of transplants from donors outside the contiguous US.
METHODS: Adult liver-only transplants from 2010 to 2022 were categorized by donor location (mainland US vs. non-mainland) using national registry data. Post-transplant survival was evaluated using time-to-event analysis, univariate and multivariable Cox regression.
RESULTS: 1531 (1.5 %) liver transplants utilized non-mainland organs (991 performed in mainland US). Non-mainland to mainland donors were older, smoked less, had a lower BMI, and less steatosis (all p < 0.05). Non-mainland organs traveled further (1241 vs. 84 miles,p < 0.01) with longer ischemic times (8.6 vs. 5.9 h,p < 0.01). Length of stay (p = 0.80) and acute rejection (p = 0.14) did not differ. Non-mainland recipients had similar survival at 1-(aHR 1.02, p = 0.85), 5-(aHR 0.93, p = 0.38), and 10-years (aHR 0.96, p = 0.56).
CONCLUSION: Non-mainland recipients had similar LOS and survival despite longer distance and cold ischemic time, emphasizing further consideration for non-mainland transplantation.
METHODS: Adult liver-only transplants from 2010 to 2022 were categorized by donor location (mainland US vs. non-mainland) using national registry data. Post-transplant survival was evaluated using time-to-event analysis, univariate and multivariable Cox regression.
RESULTS: 1531 (1.5 %) liver transplants utilized non-mainland organs (991 performed in mainland US). Non-mainland to mainland donors were older, smoked less, had a lower BMI, and less steatosis (all p < 0.05). Non-mainland organs traveled further (1241 vs. 84 miles,p < 0.01) with longer ischemic times (8.6 vs. 5.9 h,p < 0.01). Length of stay (p = 0.80) and acute rejection (p = 0.14) did not differ. Non-mainland recipients had similar survival at 1-(aHR 1.02, p = 0.85), 5-(aHR 0.93, p = 0.38), and 10-years (aHR 0.96, p = 0.56).
CONCLUSION: Non-mainland recipients had similar LOS and survival despite longer distance and cold ischemic time, emphasizing further consideration for non-mainland transplantation.