BACKGROUND: Many deceased liver donors with a history of alcohol abuse are excluded based upon medical history alone. This paper summarizes the transplant outcomes for a large number of deceased liver donors with a documented history of alcohol abuse. METHODS: The records for 1478 consecutive deceased liver donors were reviewed (2001-2012). As per the United Network for Organ Sharing criteria, heavy alcohol use by an organ donor is defined as chronic intake of two or more drinks per day. Donors with a documented history of alcohol abuse were divided into three groups according to duration of abuse (<10 years, 10-24 years and 25 + years). Reperfusion biopsies are reported. Outcomes include biopsy appearance, early graft function and early and late graft survival. RESULTS: There were 161 donors with alcohol abuse: <10 years (29%); 10-24 years (42%); and ≥25 years (29%). Risk of 90-day graft loss for these three groups was: 0%, 3% and 2%, compared to 3% for all other donors (P = 0.62). Graft survival at 1 year for donor grafts with and without alcohol abuse was 89% and 87% (P = 0.52). There was no difference in early graft function. Cox proportional hazards modelling for graft survival demonstrates no statistically significant difference in survival up to 10 years post-transplant. CONCLUSIONS: This study demonstrates successful transplantation of a large number of deceased donor liver grafts from donors with a documented history of alcohol abuse (n = 161; 11% of all grafts). These extended criteria donor allografts may, therefore, be utilized successfully with similar outcomes.
BACKGROUND: Many deceased liver donors with a history of alcohol abuse are excluded based upon medical history alone. This paper summarizes the transplant outcomes for a large number of deceased liver donors with a documented history of alcohol abuse. METHODS: The records for 1478 consecutive deceased liver donors were reviewed (2001-2012). As per the United Network for Organ Sharing criteria, heavy alcohol use by an organ donor is defined as chronic intake of two or more drinks per day. Donors with a documented history of alcohol abuse were divided into three groups according to duration of abuse (<10 years, 10-24 years and 25 + years). Reperfusion biopsies are reported. Outcomes include biopsy appearance, early graft function and early and late graft survival. RESULTS: There were 161 donors with alcohol abuse: <10 years (29%); 10-24 years (42%); and ≥25 years (29%). Risk of 90-day graft loss for these three groups was: 0%, 3% and 2%, compared to 3% for all other donors (P = 0.62). Graft survival at 1 year for donor grafts with and without alcohol abuse was 89% and 87% (P = 0.52). There was no difference in early graft function. Cox proportional hazards modelling for graft survival demonstrates no statistically significant difference in survival up to 10 years post-transplant. CONCLUSIONS: This study demonstrates successful transplantation of a large number of deceased donor liver grafts from donors with a documented history of alcohol abuse (n = 161; 11% of all grafts). These extended criteria donor allografts may, therefore, be utilized successfully with similar outcomes.
Authors: Hunter B Moore; Yanik J Bababekov; James J Pomposelli; Megan A Adams; Cara Crouch; Dor Yoeli; Rashikh A Choudhury; Tanner Ferrell; James R Burton; Elizabeth A Pomfret; Trevor L Nydam Journal: Am J Surg Date: 2022-02-19 Impact factor: 3.125
Authors: Angus Hann; Anisa Nutu; George Clarke; Ishaan Patel; Dimitri Sneiders; Ye H Oo; Hermien Hartog; M Thamara P R Perera Journal: Transpl Int Date: 2022-05-31 Impact factor: 3.842
Authors: Guilherme Moura Cunha; Tydus T Thai; Gavin Hamilton; Yesenia Covarrubias; Alexandra Schlein; Michael S Middleton; Curtis N Wiens; Alan McMillan; Rashmi Agni; Luke M Funk; Guilherme M Campos; Santiago Horgan; Garth Jacobson; Tanya Wolfson; Anthony Gamst; Jeffrey B Schwimmer; Scott B Reeder; Claude B Sirlin Journal: Abdom Radiol (NY) Date: 2020-03