High and Low Frequency Domino Liver Transplantation Centers Demonstrate Similar Performance Outcomes
| Autor: | Meredith Gunder, H. Resweber, H. Curtis, K. Nguyen, A. Di Carlo, Sunil S. Karhadkar, J. Panichella |
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| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Waiting Lists business.industry medicine.medical_treatment Graft Survival Urology Last follow up Liver transplantation Awaiting liver transplant Liver Transplantation Low volume Respiratory failure Allograft survival Living Donors Clinical endpoint medicine Humans Surgery business Donor pool Retrospective Studies |
| Zdroj: | Journal of Surgical Research. 269:144-150 |
| ISSN: | 0022-4804 |
| DOI: | 10.1016/j.jss.2021.08.016 |
| Popis: | Introduction A Domino Liver Transplant (DLT) is a successfully validated surgical option for a subset of patients awaiting liver transplant. Increased utilization of DLTs could increase the donor organ pool. However, DLTs occur primarily at a small number of high volume centers, and are rarely performed at lower volume transplant centers. This study compares DLT recipient performance outcomes between high frequency DLT centers and low frequency DLT centers. Methods The UNOS/OPTN STAR database was queried for DLTs performed at transplant centers between 1996-2018. 193 patients were identified and categorized into high (>5 DLTs) or low (≤5 DLTs) frequency centers. Our primary endpoint was allograft survival. Our secondary endpoints were graft status at last follow up and mortality secondary to cardiac, renal, or respiratory failure. Results Overall median allograft survival between high and low volume DLT centers was similar (48.2 months versus 42.7 months, P >0.314). The one-year (82% versus 76%), three-year (57% versus 56%), and five-year (45% versus 43%) survival percentages were also similar between the high and low volume DLT centers respectively. Overall mortality from cardiac (high 4% versus low 1.7%), renal (high 0.8% versus low 1.7%), or respiratory failure (high 0.8% versus low 1.7%) was similarly low in both groups. Conclusion Low volume and high volume DLT centers are associated with similar outcomes of allograft survival and mortality. DLTs should be utilized more frequently, when the criteria are met, including in centers with limited experience, to expand the donor pool, decrease time on the waitlist, and improve overall survival. Disclosures There are no disclosures. The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article. |
| Databáze: | OpenAIRE |
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