Outcomes of liver transplants utilizing donors from outside the contiguous United States

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-08-12 DOI:10.1016/j.amjsurg.2025.116568

Reed T. Jenkins , Binuri L. Hapuarachchy , Manuj M. Shah, Emily L. Larson, Alice L. Zhou, David J. Farhat, Jessica M. Ruck, Helene Rached, Elizabeth A. King, Benjamin Philosophe, Al-Faraaz Kassam

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引用次数: 0

Abstract

Purpose

Expanding the liver donor pool includes reconsidering geographic characteristics. We evaluated demographics, trends, and outcomes of transplants from donors outside the contiguous US.

Methods

Adult liver-only transplants from 2010 to 2022 were categorized by donor location (mainland US vs. non-mainland) using national registry data. Post-transplant survival was evaluated using time-to-event analysis, univariate and multivariable Cox regression.

Results

1531 (1.5 %) liver transplants utilized non-mainland organs (991 performed in mainland US). Non-mainland to mainland donors were older, smoked less, had a lower BMI, and less steatosis (all p < 0.05). Non-mainland organs traveled further (1241 vs. 84 miles,p < 0.01) with longer ischemic times (8.6 vs. 5.9 h,p < 0.01). Length of stay (p = 0.80) and acute rejection (p = 0.14) did not differ. Non-mainland recipients had similar survival at 1-(aHR 1.02, p = 0.85), 5-(aHR 0.93, p = 0.38), and 10-years (aHR 0.96, p = 0.56).

Conclusion

Non-mainland recipients had similar LOS and survival despite longer distance and cold ischemic time, emphasizing further consideration for non-mainland transplantation.

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使用美国本土以外的供体进行肝移植的结果

目的扩大肝供体池包括重新考虑地理特征。我们评估了美国以外地区供体移植的人口统计、趋势和结果。方法使用国家登记数据，按供体地点（美国大陆与非大陆）对2010年至2022年的成人单肝移植进行分类。移植后生存率采用时间-事件分析、单变量和多变量Cox回归进行评估。结果1531例（1.5%）肝移植使用非大陆器官，其中991例在美国大陆进行。非大陆到大陆捐献者年龄较大，吸烟较少，BMI较低，脂肪变性较少（均p <； 0.05）。非大陆器官移动更远（1241比84英里，p < 0.01），缺血时间更长（8.6比5.9小时，p < 0.01）。住院时间（p = 0.80）和急性排斥反应（p = 0.14）无差异。非大陆接受者的生存率相似，分别为1年（aHR 1.02, p = 0.85）、5年（aHR 0.93, p = 0.38）和10年（aHR 0.96, p = 0.56）。结论非大陆受者虽然距离较远，冷缺血时间较长，但LOS和生存率相近，值得进一步考虑非大陆移植。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.