A Decade of Liver Transplantation in the United States: Drivers of Discard and Underutilization

Autor: Julia Torabi, MD, Rachel Todd, BA, L. Leonie van Leeuwen, PhD, Yuki Bekki, MD, Matthew Holzner, MD, Jang Moon, MD, Tom Schiano, MD, Sander S. Florman, MD, Mohammed Zeeshan Akhtar, BM, BCh, FRCS
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Transplantation Direct, Vol 10, Iss 6, p e1605 (2024)
Druh dokumentu: article
ISSN: 2373-8731
00000000
DOI: 10.1097/TXD.0000000000001605
Popis: Background:. Organ shortage remains a major challenge for the field of transplantation. Maximizing utilization and minimizing discard of available organs is crucial to reduce waitlist times. Our aim was to investigate the landscape of liver recovery, discard over the past decade in the United States, and identify areas to reduce organ discard. Methods:. This study used the Scientific Registry of Transplant Recipients United Network for Organ Sharing database to analyze the rates and associated reasons of discarded organs from 2010 to 2021. All deceased donors were evaluated, and data were analyzed by organ type, year, and region. Organ disposition was analyzed by year and region. Donor demographics and liver biopsy data were also analyzed. Results:. The volume of liver transplantation increased steadily, with a 44% increase from 2010 to 2021. Donation after circulatory death transplantation increased by 239%, comprising 10.6% of transplants in 2021, yet discard rates remained high at 30% for this donor subset. For all donor types, the liver discard rate has remained stable around 10% despite a 74% increase in available donors. Seventy percent of liver discards were attributed to organ factors, with biopsy findings accounting for 40% of all discards. Of livers that were biopsied, 70% had macrosteatosis of
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