The impact of perceived donor liver quality on post‐transplant outcome

Abstract

AbstractBackgroundWe analysed the impact of perceived liver donor quality on transplant recipient outcomes.Methodsthis prospective cohort study included all deceased liver donors during 2008–2018 in the Swiss Transplant Cohort Study. Perceived low‐quality liver donors were defined when refused for ≥5 top listed recipients or for all recipients in at least one centre before being transplanted. The effect of liver donor quality on relisting or recipient death at 1 week and 1 year after transplantation was analysed using Kaplan–Meier and Cox proportional hazard models. A 1:3 matching was also performed using a recipient score.ResultsOf 973 liver donors, 187 (19.2%) had perceived poor‐quality. Males, obesity, donation after circulatory death and alanine aminotransferase values were significantly associated with perceived poor‐quality, with no significant effect of the perceived quality on re‐listing or death within the first week and first year post‐transplant [(aHR) = 1.45, 95% CI: (0.6, 3.5), P = 0.41 and aHR = 1.52 (95% CI 0.98–2.35), P = 0.06], adjusting by recipient age and gender, obesity, diabetes, prior liver transplantation and model for end‐stage liver disease (MELD) score. At 1 year, prior liver transplantation and higher MELD score associated with higher risk of re‐listing or death.ConclusionComparable post‐transplant outcomes with different perceived quality liver donors stresses the need to improve donor selection in liver transplantation.