TY - JOUR
T1 - Comparable graft survival is achievable with the usage of donation after circulatory death liver grafts from donors at or above 70 years of age
T2 - A long-term UK national analysis
AU - Giorgakis, Emmanouil
AU - Khorsandi, Shirin E.
AU - Mathur, Amit K.
AU - Burdine, Lyle
AU - Jassem, Wayel
AU - Heaton, Nigel
N1 - Publisher Copyright:
© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons
PY - 2021/6
Y1 - 2021/6
N2 - The aim of the study was to assess the UK donation after circulatory death (DCD) liver transplant experience from donors ≥70 years. Nationwide UK DCD retrospective analysis was conducted between 2001 and 2015 (n = 1163). Recipients were divided into group 1 vs. group 2 (donors 70≥ vs. <70 years, respectively). group 1 (n = 69, 5.9%) recipients were older (median 59 vs. 55 years, p =.001) and had longer waitlist time (128 vs. 84 days; p =.039). 94.2% of group 1 clustered in London and Birmingham, where the two busiest centers are located. group 1 allografts had higher UKDRI and UK DCD Risk Scores but similar WIT and CIT and were more likely to have been imported. Both groups had similar 1-, 3-, and 5-year graft survival (group 1, 90%, 81.4%, and 74% vs. group 2, 88.6%, 81.4%, and 78.6%, respectively; p =.54). Both groups had similar ICU stay length (p =.22), 3-month hepatic artery thrombosis rates (4.4% vs 4.0%; p =.9), and 12-month readmission rates for all biliary complications (20.3% vs 25.7%; p =.32). This study demonstrates that acceptable outcomes are achievable using older grafts in a highly selected cohort at experienced centers. Advanced age should not be an absolute contraindication to utilizing a DCD graft from donors aged ≥70 years.
AB - The aim of the study was to assess the UK donation after circulatory death (DCD) liver transplant experience from donors ≥70 years. Nationwide UK DCD retrospective analysis was conducted between 2001 and 2015 (n = 1163). Recipients were divided into group 1 vs. group 2 (donors 70≥ vs. <70 years, respectively). group 1 (n = 69, 5.9%) recipients were older (median 59 vs. 55 years, p =.001) and had longer waitlist time (128 vs. 84 days; p =.039). 94.2% of group 1 clustered in London and Birmingham, where the two busiest centers are located. group 1 allografts had higher UKDRI and UK DCD Risk Scores but similar WIT and CIT and were more likely to have been imported. Both groups had similar 1-, 3-, and 5-year graft survival (group 1, 90%, 81.4%, and 74% vs. group 2, 88.6%, 81.4%, and 78.6%, respectively; p =.54). Both groups had similar ICU stay length (p =.22), 3-month hepatic artery thrombosis rates (4.4% vs 4.0%; p =.9), and 12-month readmission rates for all biliary complications (20.3% vs 25.7%; p =.32). This study demonstrates that acceptable outcomes are achievable using older grafts in a highly selected cohort at experienced centers. Advanced age should not be an absolute contraindication to utilizing a DCD graft from donors aged ≥70 years.
KW - clinical research/practice
KW - donors and donation: donation after circulatory death (DCD)
KW - donors and donation: extended criteria
KW - liver transplantation/hepatology
KW - organ acceptance
KW - organ allocation
KW - organ procurement
KW - organ procurement and allocation
UR - http://www.scopus.com/inward/record.url?scp=85100217994&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85100217994&partnerID=8YFLogxK
U2 - 10.1111/ajt.16409
DO - 10.1111/ajt.16409
M3 - Article
C2 - 33222386
AN - SCOPUS:85100217994
SN - 1600-6135
VL - 21
SP - 2200
EP - 2210
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 6
ER -