Should more donation after cardiac death livers be used in pediatric transplantation?

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: There is a mismatch that exists in donor liver organ supply and demand. DCD livers represents a potential source to increase the number of liver grafts available for use in pediatric recipients; however, there has been hesitancy to use such organs. We evaluated patient and allograft outcomes in pediatric liver transplant recipients of DCD livers. Methods: The UNOS database was queried to examine outcomes in all liver transplant recipients from 1993 to 2017. Patients were then divided according to adult and pediatric status, DBD or DCD allograft status, and era of transplant. Donor and recipient demographic data were examined, and patient and allograft survival were calculated. A P-value of <0.05 was considered to be significant. Results: A total of 57 pediatric recipients received a DCD liver allograft. DCD recipients were older than DBD recipients. There was no difference in the final PELD score between the groups. There were no differences in causes of allograft failure between the DCD and DBD groups. Importantly, the overall allograft survival in the DCD and DBD groups was similar, as was allograft survival based on era. Conclusion: Pediatric liver transplant recipients of DCD allografts have comparable patient and allograft survival when compared to DBD allograft recipients. Use of DCD allografts in the pediatric liver transplant population should be strongly considered to increase the donor organ pool.

Original languageEnglish (US)
Article numbere13323
JournalPediatric Transplantation
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Allografts
Transplantation
Pediatrics
Liver
Tissue Donors
Transplants
dicarboxydine
Demography
Databases

Keywords

  • donation after cardiac death
  • marginal donors
  • pediatric

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

@article{6d60c935c7c94271ac83dd3736e6a317,
title = "Should more donation after cardiac death livers be used in pediatric transplantation?",
abstract = "Introduction: There is a mismatch that exists in donor liver organ supply and demand. DCD livers represents a potential source to increase the number of liver grafts available for use in pediatric recipients; however, there has been hesitancy to use such organs. We evaluated patient and allograft outcomes in pediatric liver transplant recipients of DCD livers. Methods: The UNOS database was queried to examine outcomes in all liver transplant recipients from 1993 to 2017. Patients were then divided according to adult and pediatric status, DBD or DCD allograft status, and era of transplant. Donor and recipient demographic data were examined, and patient and allograft survival were calculated. A P-value of <0.05 was considered to be significant. Results: A total of 57 pediatric recipients received a DCD liver allograft. DCD recipients were older than DBD recipients. There was no difference in the final PELD score between the groups. There were no differences in causes of allograft failure between the DCD and DBD groups. Importantly, the overall allograft survival in the DCD and DBD groups was similar, as was allograft survival based on era. Conclusion: Pediatric liver transplant recipients of DCD allografts have comparable patient and allograft survival when compared to DBD allograft recipients. Use of DCD allografts in the pediatric liver transplant population should be strongly considered to increase the donor organ pool.",
keywords = "donation after cardiac death, marginal donors, pediatric",
author = "Hwang, {Christine S} and Levea, {Swee-Ling L} and Justin Parekh and Yun Liang and Desai, {Dev M} and MacConmara, {Malcolm P}",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/petr.13323",
language = "English (US)",
journal = "Pediatric Transplantation",
issn = "1397-3142",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Should more donation after cardiac death livers be used in pediatric transplantation?

AU - Hwang, Christine S

AU - Levea, Swee-Ling L

AU - Parekh, Justin

AU - Liang, Yun

AU - Desai, Dev M

AU - MacConmara, Malcolm P

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: There is a mismatch that exists in donor liver organ supply and demand. DCD livers represents a potential source to increase the number of liver grafts available for use in pediatric recipients; however, there has been hesitancy to use such organs. We evaluated patient and allograft outcomes in pediatric liver transplant recipients of DCD livers. Methods: The UNOS database was queried to examine outcomes in all liver transplant recipients from 1993 to 2017. Patients were then divided according to adult and pediatric status, DBD or DCD allograft status, and era of transplant. Donor and recipient demographic data were examined, and patient and allograft survival were calculated. A P-value of <0.05 was considered to be significant. Results: A total of 57 pediatric recipients received a DCD liver allograft. DCD recipients were older than DBD recipients. There was no difference in the final PELD score between the groups. There were no differences in causes of allograft failure between the DCD and DBD groups. Importantly, the overall allograft survival in the DCD and DBD groups was similar, as was allograft survival based on era. Conclusion: Pediatric liver transplant recipients of DCD allografts have comparable patient and allograft survival when compared to DBD allograft recipients. Use of DCD allografts in the pediatric liver transplant population should be strongly considered to increase the donor organ pool.

AB - Introduction: There is a mismatch that exists in donor liver organ supply and demand. DCD livers represents a potential source to increase the number of liver grafts available for use in pediatric recipients; however, there has been hesitancy to use such organs. We evaluated patient and allograft outcomes in pediatric liver transplant recipients of DCD livers. Methods: The UNOS database was queried to examine outcomes in all liver transplant recipients from 1993 to 2017. Patients were then divided according to adult and pediatric status, DBD or DCD allograft status, and era of transplant. Donor and recipient demographic data were examined, and patient and allograft survival were calculated. A P-value of <0.05 was considered to be significant. Results: A total of 57 pediatric recipients received a DCD liver allograft. DCD recipients were older than DBD recipients. There was no difference in the final PELD score between the groups. There were no differences in causes of allograft failure between the DCD and DBD groups. Importantly, the overall allograft survival in the DCD and DBD groups was similar, as was allograft survival based on era. Conclusion: Pediatric liver transplant recipients of DCD allografts have comparable patient and allograft survival when compared to DBD allograft recipients. Use of DCD allografts in the pediatric liver transplant population should be strongly considered to increase the donor organ pool.

KW - donation after cardiac death

KW - marginal donors

KW - pediatric

UR - http://www.scopus.com/inward/record.url?scp=85056776310&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85056776310&partnerID=8YFLogxK

U2 - 10.1111/petr.13323

DO - 10.1111/petr.13323

M3 - Article

C2 - 30447034

AN - SCOPUS:85056776310

JO - Pediatric Transplantation

JF - Pediatric Transplantation

SN - 1397-3142

M1 - e13323

ER -