Effect of airplane transport of donor livers on post-liver transplantation survival retrospective cohort study

Yi Huang, Gerry Macquillan, Leon Adams, George Garas, M. Collins, A. Nwaba, L. Mou, M.K. Bulsara, L. Delriviere, Gary Jeffrey

Research output: Contribution to journalArticle

Abstract

© 2016 Baishideng Publishing Group Inc. All rights reserved.AIM To evaluate the effect of long haul airplane transport of donor livers on post-Transplant outcomes. METHODS A retrospective cohort study of patients who received a liver transplantation was performed in Perth, Australia from 1992 to 2012. Donor and recipient characteristics information were extracted from Western Australian liver transplantation service database. Patients were followed up for a mean of six years. Patient and graft survival were evaluated and compared between patients who received a local donor liver and those who received an airplane transported donor liver. Predictors of survival were determined by univariate and multivariate analysis using cox regression. RESULTS One hundred and ninety-Three patients received a local donor liver and 93 patients received an airplane transported donor liver. Airplane transported livers had a significantly lower alanine transaminase (mean: 45 U/L vs 84 U/L, P = 0.035), higher donor risk index (mean: 1.88 vs 1.42, P 0.001) and longer cold ischemic time (CIT) (mean: 10.1 h vs 6.4 h, P 0.001). There was a weak correlation between CIT and transport distance (r 2 = 0.29, P 0.001). Mean follow up was six years and 93 patients had graft failure. Multivariate analysis found only airplane transport retained significance for graft loss (HR = 1.92, 95%CI: 1.16-3.17). One year graft survival was 0.88 for those with a local liver and was 0.71 for those with an airplane transported liver. One year graft loss was due to primary graft non-function or associated with preservation injury in 20.8% of recipients of an airplane transported liver compared with 4.6% in those with a local liver (P = 0.027). CONCLUSION Airplane transport of donor livers was independently associated with reduced graft survival following liver transplantation.
Original languageEnglish
Pages (from-to)9154-9161
JournalWorld Journal of Gastroenterology
Volume22
Issue number41
DOIs
Publication statusPublished - 2016

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