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Donor-Recipient Height Mismatch Is Associated With Decreased Survival in Pediatric-to-Adult Liver Transplant Recipients.

Publication ,  Journal Article
Kesseli, SJ; Samoylova, ML; Yerxa, J; Moore, CB; Cerullo, M; Gao, Q; Abraham, N; Patel, YA; McElroy, LM; Vikraman, D; Barbas, AS
Published in: Liver Transpl
February 2021

Liver grafts from pediatric donors represent a small fraction of grafts transplanted into adult recipients, and their use in adults requires special consideration of donor size to prevent perioperative complications. In the past, graft weight or volume ratios have been adopted from the living donor liver transplant literature to guide clinicians; however, these metrics are not regularly available to surgeons accepting deceased donor organs. In this study, we evaluated all pediatric-to-adult liver transplants in the United Network for Organ Sharing Standard Transplant Analysis and Research database from 1987 to 2019, stratified by donor age and donor-recipient height mismatch ratio (HMR; defined as donor height/recipient height). On multivariable regression controlling for cold ischemia time, age, and transplantation era, the use of donors from ages 0 to 4 and 5 to 9 had increased risk of graft failure (hazard ratio [HR], 1.81 [P < 0.01] and HR, 1.16 [P < 0.01], respectively) compared with donors aged 15 to 17. On Kaplan-Meier survival analysis, a HMR < 0.8 was associated with inferior graft survival (mean, 11.8 versus 14.6 years; log-rank P < 0.001) and inferior patient survival (mean, 13.5 versus 14.9 years; log-rank P < 0.01) when compared with pairs with similar height (HMR, 0.95-1.05; ie, donors within 5% of recipient height). This study demonstrates that both young donor age and low HMR confer additional risk in adult recipients of pediatric liver grafts.

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Published In

Liver Transpl

DOI

EISSN

1527-6473

Publication Date

February 2021

Volume

27

Issue

3

Start / End Page

425 / 433

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplant Recipients
  • Tissue and Organ Procurement
  • Tissue Donors
  • Surgery
  • Retrospective Studies
  • Living Donors
  • Liver Transplantation
  • Kaplan-Meier Estimate
  • Humans
 

Citation

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Kesseli, S. J., Samoylova, M. L., Yerxa, J., Moore, C. B., Cerullo, M., Gao, Q., … Barbas, A. S. (2021). Donor-Recipient Height Mismatch Is Associated With Decreased Survival in Pediatric-to-Adult Liver Transplant Recipients. Liver Transpl, 27(3), 425–433. https://doi.org/10.1002/lt.25937
Kesseli, Samuel J., Mariya L. Samoylova, John Yerxa, Carrie B. Moore, Marcelo Cerullo, Qimeng Gao, Nader Abraham, et al. “Donor-Recipient Height Mismatch Is Associated With Decreased Survival in Pediatric-to-Adult Liver Transplant Recipients.Liver Transpl 27, no. 3 (February 2021): 425–33. https://doi.org/10.1002/lt.25937.
Kesseli SJ, Samoylova ML, Yerxa J, Moore CB, Cerullo M, Gao Q, et al. Donor-Recipient Height Mismatch Is Associated With Decreased Survival in Pediatric-to-Adult Liver Transplant Recipients. Liver Transpl. 2021 Feb;27(3):425–33.
Kesseli, Samuel J., et al. “Donor-Recipient Height Mismatch Is Associated With Decreased Survival in Pediatric-to-Adult Liver Transplant Recipients.Liver Transpl, vol. 27, no. 3, Feb. 2021, pp. 425–33. Pubmed, doi:10.1002/lt.25937.
Kesseli SJ, Samoylova ML, Yerxa J, Moore CB, Cerullo M, Gao Q, Abraham N, Patel YA, McElroy LM, Vikraman D, Barbas AS. Donor-Recipient Height Mismatch Is Associated With Decreased Survival in Pediatric-to-Adult Liver Transplant Recipients. Liver Transpl. 2021 Feb;27(3):425–433.
Journal cover image

Published In

Liver Transpl

DOI

EISSN

1527-6473

Publication Date

February 2021

Volume

27

Issue

3

Start / End Page

425 / 433

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplant Recipients
  • Tissue and Organ Procurement
  • Tissue Donors
  • Surgery
  • Retrospective Studies
  • Living Donors
  • Liver Transplantation
  • Kaplan-Meier Estimate
  • Humans