A Single Center Experience of the Prognosis After Liver Transplantation From Discarded Graft Due to Poor Graft Conditions in Prioritized Centers

Transplant Proc. 2022 Mar;54(2):412-417. doi: 10.1016/j.transproceed.2021.10.024. Epub 2022 Jan 20.

Abstract

Background: Liver transplantation (LT) has the limitation of graft shortage. Therefore, to increase the donor pool, even marginal grafts are being transplanted depending on the recipient's condition. This study was conducted to analyze the post-LT prognosis using discarded liver grafts.

Methods and materials: From January 2010 to September 2020, deceased-donor LT was performed in 160 patients in our center. Among them, 121 patients (allocated group) were preferentially allocated to our center, and the remaining 39 patients (24.4%, discarded group) received liver grafts that were discarded by prioritized centers.

Results: The preoperative model for end-stage liver disease score were 27.0 ± 10.41 and 27.0 ±11.79 for each group (P = .99). There were no differences between the 2 groups in operation time (P = .06) and intraoperative packed red cell transfusion (P = .90). There were no differences between the 2 groups in early allograft dysfunction (P = .48) and hospital stay (P = .26) after deceased-donor LT. In-hospital mortality occurred in 10 patients (8.3%) in the allocated group and 4 patients (10.3%) in the discarded group. Only the length of intensive care unit stay was significantly longer in the discarded group (P = 0.04). The 5-year survival rate was 73.8% in the allocated group and 72.2% in the discarded group.

Conclusions: The outcome of the discarded group is never worse than that of the allocated group. deceased-donor LT from the discarded graft can be acceptable. As a result, the number of discarded grafts can be reduced.

MeSH terms

  • End Stage Liver Disease*
  • Graft Survival
  • Humans
  • Liver Transplantation* / methods
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Tissue Donors
  • Treatment Outcome