Deceased Donor Predictors for Pediatric Liver Allograft Utilization

Area of Science:

• Organ Transplantation
• Pediatric Surgery
• Hepatology

Background:

• Declining numbers of pediatric deceased organ donors.
• Nonutilization of pediatric liver allografts limits liver transplantation development.
• Need to determine pediatric liver allograft utilization rates and discard risk factors.

Purpose of the Study:

• Determine the utilization rate of pediatric liver allografts.
• Identify risk factors associated with pediatric liver graft discard.

Main Methods:

• Utilized data from the Scientific Registry of Transplant Recipients (SRTR) database (2000-2012).
• Analyzed trends in pediatric liver donors and allograft utilization rates.
• Employed logistic regression modeling to assess graft utilization and identify risk factors.

Main Results:

• Identified 11,934 eligible pediatric liver donors; 1191 grafts were not utilized.
• Factors associated with nonutilization included donor age >1 year, non-head trauma, asystole, hepatitis B/C positivity, elevated bilirubin, and high blood urea nitrogen.
• Prerecovery administration of steroids or diuretics was linked to increased graft utilization.

Conclusions:

• Established pediatric liver allograft utilization rates.
• Identified key risk factors contributing to pediatric liver graft nonutilization.
• Findings can inform strategies to improve the use of pediatric liver grafts in transplantation.