Outcomes of liver transplants utilizing donors from outside the contiguous United States.
Publication/Presentation Date
11-1-2025
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.
Volume
249
First Page
116568
Last Page
116568
ISSN
1879-1883
Published In/Presented At
Jenkins, R. T., Hapuarachchy, B. L., Shah, M. M., Larson, E. L., Zhou, A. L., Farhat, D. J., Ruck, J. M., Rached, H., King, E. A., Philosophe, B., & Kassam, A. F. (2025). Outcomes of liver transplants utilizing donors from outside the contiguous United States. American journal of surgery, 249, 116568. https://doi.org/10.1016/j.amjsurg.2025.116568
Disciplines
Medicine and Health Sciences
PubMedID
40848472
Department(s)
Department of Surgery
Document Type
Article