Association of donor hepatectomy time with liver transplantation outcomes: A multicenter retrospective study

Abstract

Background: Prolonged donor hepatectomy time may be implicated in early and late complications of liver transplantation.

Aim: To evaluate the impact of donor hepatectomy time on outcomes of liver transplant recipients, mainly early allograft dysfunction.

Methods: This multicenter retrospective study included brain-dead donors and adult liver graft recipients. Donor-recipient matching was obtained through a crossover list. Clinical and laboratory data were recorded for both donors and recipients. Donor hepatectomy, cold ischemia, and warm ischemia times were recorded. Primary outcome was early allograft dysfunction. Secondary outcomes included need for retransplantation, length of intensive care unit and hospital stay, and patient and graft survival at 12 months.

Results: From January 2019 to December 2021, a total of 243 patients underwent a liver transplant from a brain-dead donor. Of these, 57 (25%) developed early allograft dysfunction. The median donor hepatectomy time was 29 (23-40) min. Patients with early allograft dysfunction had a median hepatectomy time of 25 (22-38) min, whereas those without it had a median time of 30 (24-40) min (P = 0.126).

Conclusion: Donor hepatectomy time was not associated with early allograft dysfunction, graft survival, or patient survival following liver transplantation.

Keywords: Brain death; Early allograft dysfunction; Graft survival; Hepatectomy; Liver transplantation.

Figure 1

Kaplan-Meir curve illustrating the probability of graft and patient survival after liver transplantation according to donor hepatectomy time. A: Kaplan-Meir curve illustrating the probability of graft; B: Patient survival after liver transplantation according to donor hepatectomy time.