Accepting multiple simultaneous liver offers does not negatively impact transplant outcomes

Area of Science:

• Transplantation Surgery
• Hepatology
• Organ Transplantation

Background:

• The impact of performing multiple liver transplants (LT) in rapid succession is not well understood.
• Consecutive LT may increase complication risks due to team fatigue, resource strain, and prolonged ischemia times.

Purpose of the Study:

• To analyze the outcomes of consecutive liver transplants (CLT) compared to solitary liver transplants (SLT).
• To assess the safety and efficiency of performing CLT in a high-volume center setting.

Main Methods:

• Retrospective analysis of 1702 LT procedures, identifying 314 (18.4%) as CLT.
• Comparison of outcome data between CLT and SLT groups, controlling for recipient, donor, and graft characteristics.
• Analysis of implantation time, operative time, and early hepatic artery thrombosis (E-HAT) rates.

Main Results:

• CLT recipients had significantly shorter implantation and operative times compared to SLT.
• A higher incidence of E-HAT was observed in CLT versus SLT (P=0.038), though absolute numbers were low.
• Second LT in CLT utilized younger donor grafts with longer cold ischemic times.

Conclusions:

• Consecutive liver transplants are safe and pragmatically utilize organs in high-volume centers.
• CLT may help reduce organ discard and waiting list mortality.
• Careful monitoring for E-HAT is warranted in CLT, with a trend towards higher rates in the first of the consecutive procedures.