Primary Team Versus Local Recovery in Liver Transplantation in the Modern Era: A National Analysis of the United Network for Organ Sharing Database

• DOI: 10.1111/ctr.15418
• Publication Date: 2024-08-08T14:19:41Z
• Authors: Jenna N. Whitrock; Stephanie Sisak; Catherine G. Pratt; Aaron M. Delman; Adam D. Price; Koffi Wima; Shimul A. Shah; Ralph Cutler Quillin
• Keywords: Male; Adult; Patient Care Team; Tissue and Organ Procurement; Databases, Factual; SARS-CoV-2; Graft Survival; COVID-19; Middle Aged; United States; Tissue Donors; Liver Transplantation; Survival Rate; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Aged

ABSTRACT Background The implementation of acuity circles (AC) in 2020 and the COVID‐19 pandemic increased use local surgeons to recover livers for transplant; however, impact on liver transplant (LT) outcomes is unknown. Methods Deceased donor adult LT recipients from UNOS database were identified. Recipients grouped by surgeon: versus primary recovery. Patient graft survival as well trends recovery 2 years pre‐AC post‐AC assessed. Results utilization 22.3% 37.9% ( p < 0.01). LTs with had longer cold ischemia times (6.5 h [5.4–7.8] vs. 5.3 [4.4–6.5], 0.01) traveled further (210 miles [89–373] 73 [11–196], than those using Multivariate analyses revealed no differences patient or between recovery, OPO surgeon. There was difference when comparing simultaneous liver–kidney, donation after circulatory death, MELD ≥ 30, redo‐LT team. Recovery rates also noted be higher (51.4% 48.6% pre‐AC, recovered allografts (72.5% 66.0%, Conclusion Nearly 40% are performed continue change changing organ‐sharing paradigms such AC. This practice appears safe similar team appropriately selected may lead access ability more livers.