Poster 20. Liver donors with metabolic disturbances can extend the donor pool

Thursday 14 march 2019

12:42 - 12:45h

Categories: Klinisch, Postersessie

Parallel session: Postersessies 4 - Clinical

M. van Reeven1, I. Vasiliauskaite1, S. Darwish Murad2, W.G. Polak1, R.W.F. de Bruin3, J.N.M. IJzermans1

1Dept. of Surgery, Division of Hepatopancreatobiliary and Transplant Surgery, 2Dept. of Gastroenterology and Hepatology, 3Dept. of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.

Background: Metabolic complications after liver transplantation (LT) are common and affect graft and patient survival. To increase the donor pool sufficiently, more grafts from donors with metabolic disturbances are used for transplantation. Furthermore, due to our Western lifestyle, metabolic comorbidities will become more common among potential organ donors. Thus, it’s important to determine whether livers from these donors can be used safely and do not derogate long term graft and patient survival after LT. 

Methods: Data from liver donors and recipients who underwent full-size LT between 2007 and 2011 were collected. The effect of donor age, Body Mass Index (BMI), hypertension, dyslipidemia, steatosis, smoking, alcohol use, in combination with known non-metabolic risk factors, such as warm ischemia time (WIT) and cold ischemia time (CIT) on graft and patient survival was analyzed. Recipient age, BMI and non-alcoholic steatohepatitis, as an indication for LT, was also included in the models.

Results: A total of 211 LT were performed (DBD n = 166, DCD n = 45). The 1-, 5- and 10-year overall graft survival was 79%, 58%, and 45%. Patient survival was 85% at year 1, 68% at year 5 and 51% at year 10 post-transplantation. In multivariable analysis, donor hypertension (p=0.369), dyslipidemia (p=0.165), steatosis grade (10-20% p=0.519, 20-33% p=0.337, >33% p=0.601), smoking (p=0.986) or alcohol abuse (p=0.638) had no significant effect on patient survival. Similar results were seen for graft survival. In all models, independent risk factors for graft survival were donor obesity and WIT.

Conclusions: These data suggest that graft and patient survival after LT is not influenced by donor hypertension, dyslipidemia, steatosis, smoking, or alcohol abuse. Our results imply that the donor pool can be safely expanded using donors with metabolic disturbances.