Disparities in the Use of Older Donation After Circulatory Death Liver Allografts in the United States Versus the United Kingdom

This study aimed to assess the differences between the United States and the United Kingdom in the characteristics and posttransplant survival of patients who received donation after circulatory death (DCD) liver allografts from donors aged>60 y. Methods. Data were collected from the UK Transplant Registry and the United Network for Organ Sharing databases. Cohorts were dichotomized into donor age subgroups (donor>60 y [D>60]; donor ≤60 y [D ≤60]). Study period: January 1, 2001, to December 31, 2015. Results. 1157 DCD LTs were performed in the United Kingdom versus 3394 in the United States. Only 13.8% of US DCD donors were aged>50 y, contrary to 44.3% in the United Kingdom. D>60 were 22.6% in the United Kingdom versus 2.4% in the United States. In the United Kingdom, 64.2% of D>60 clustered in 2 metropolitan centers. In the United States, there was marked inter-regional variation. A total of 78.3% of the US DCD allografts were used locally. One- and 5-y unadjusted DCD graft survival was higher in the United Kingdom versus the United States (87.3% versus 81.4%, and 78.0% versus 71.3%, respectively; P 60 graft survival was higher in the United Kingdom (87.3% versus 68.1%, and 77.9% versus 51.4%, United Kingdom versus United States, respectively; P 60 survival. Nonetheless, present data indicate similar survivals for older donors aged ≤60, supporting an extension to the current US DCD age cutoff.
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research