Effects of a Domino Liver Transplantation Program on Patient Survival and Waiting List Time: A Single-Center Retrospective Study

Karadagi, Ahmad; Guthrie, Viktor Renneus; Kjaernet, Felicia; Ericzon, Bo‐Göran; Nowak, Greg

doi:10.1016/j.transproceed.2021.09.021

Cited by 2 publications

(18 citation statements)

References 28 publications

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“…Overall, there were 945 patients who received either a DLT (n = 409) or a DDLT (n = 536). Four studies [5][6][7]9 were conducted in Europe using retrospective databases, whereas one study 8 was performed in the United States, utilizing the United Network for Organ Sharing dataset (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…All included studies reported the recipient age, which was significantly higher in the DLT group (56.9 ± 2.0 vs 54.1 ± 3.8, P = 0.04). Four studies 5,[7][8][9] reported the recipient lab MELD, which was comparable between the two groups (14.4 ± 2.2 vs 14.5 ± 2.6, P = 0.97). Regarding the graft preservation time, four studies [5][6][7]9 reported the CIT, which was comparable between both groups (425.5 ± 57.4 min vs 498.2 ± 18.2 min, P = 0.13).…”

Section: Domino or Deceased Livers: Meta-analysismentioning

confidence: 92%

“…The baseline characteristics of the study population and the tumor are summarized in (Table S1). Three studies 5,7,9 reported donor age, which was significantly lower in DLT (40.1 ± 8.6 vs 56.6 ± 6.3, P = 0.003). Four [5][6][7]9 studies illustrated the domino graft index hereditary disease, which was FAP in all cases, for a total of 286 patients.…”

Section: Domino or Deceased Livers: Meta-analysismentioning

confidence: 99%

“…Three studies 5,7,9 reported donor age, which was significantly lower in DLT (40.1 ± 8.6 vs 56.6 ± 6.3, P = 0.003). Four [5][6][7]9 studies illustrated the domino graft index hereditary disease, which was FAP in all cases, for a total of 286 patients. Recipients were mostly male with 79.4% (325/ 409) and 76.8% (412/536) in DLT and DDLT groups, respectively (P = 0.25).…”

Section: Domino or Deceased Livers: Meta-analysismentioning

confidence: 99%

“…Although several single-center studies have compared the outcomes of DLT and DDLT, most were retrospective, demonstrating adequate but somewhat conflicting results. [5][6][7][8][9] A French study showed a shorter waitlist time of 195 ± 156 days compared to 326 ± 250 days for DLT and DDLT, respectively 6 ; however, this was not confirmed in a larger study using data from the United States. 8 In addition, severe posttransplant complications were noted by a group from Portugal, 7 which included piggyback syndrome, vascular complications, hemorrhage requiring reoperation, and biliary complications.…”

Section: Introductionmentioning

confidence: 95%

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Clinical outcomes after transplantation of domino grafts or standard deceased donor livers: a systematic review and meta‐analysis

Parente,

Milana,

Hajibandeh

et al. 2024

J of Gastro and Hepatol

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Background and AimDomino liver transplantation (DLT) utilizes otherwise discarded livers as donor grafts for another recipients. It is unclear whether DLT has less favorable outcomes compared to deceased donor liver transplantation (DDLT). We aimed to assess the outcomes of DLT compared to DDLT.MethodsMEDLINE, Embase, and Web of Science database were searched to identify studies comparing outcomes after DLT with DDLT. Data were pooled using random‐effects modeling, evaluating odds ratios (OR) or mean difference (MD) for outcomes including waiting list time, severe hemorrhage, intensive care unit (ICU), length hospital stay (LOS), rejection, renal, vascular, and biliary events, and recipient survival at 1, 3, 5, and 10 years.ResultsFive studies were identified including 945 patients (DLT = 409, DDLT = 536). The DLT recipients were older compared to the DDLT group (P = 0.04), and both cohorts were comparable regarding lab MELD, hepatocellular carcinoma, and waitlist time. There were no differences in vascular (OR: 1.60, P = 0.39), renal (OR: 0.62, P = 0.24), biliary (OR: 1.51, P = 0.21), severe hemorrhage (OR: 1.09, P = 0.86), rejection (OR: 0.78, P = 0.51), ICU stay (MD: 0.50, P = 0.21), or LOS (MD: 1.68, P = 0.46) between DLT and DDLT. DLT and DDLT were associated with comparable 1‐year (78.9% vs 80.4%; OR: 1.03, P = 0.89), 3‐year (56.2% vs 54.1%; OR: 1.35, P = 0.07), and 10‐year survival (6.5% vs 8.5%; OR: 0.8, P = 0.67) rates. DLT was associated with higher 5‐year survival (41.6% vs 36.4%; OR: 1.70; P = 0.003) compared to DDLT, which was not confirmed at sensitivity analysis.ConclusionThis meta‐analysis of the best available evidence (Level 2a) demonstrated that DLT and DDLT have comparable outcomes. As indications for liver transplantation expand, future high‐quality research is encouraged to increase the DLT numbers in clinical practice, serving the growing waiting list candidates, with the caveat of uncertain de novo disease transmission risks.

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Section: Resultsmentioning

confidence: 99%

Section: Domino or Deceased Livers: Meta-analysismentioning

confidence: 92%

Section: Domino or Deceased Livers: Meta-analysismentioning

confidence: 99%

Section: Domino or Deceased Livers: Meta-analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

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Clinical outcomes after transplantation of domino grafts or standard deceased donor livers: a systematic review and meta‐analysis

Parente,

Milana,

Hajibandeh

et al. 2024

J of Gastro and Hepatol

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Lesson learnt from 60 years of liver transplantation: Advancements, challenges, and future directions

Gadour

2025

World J Transplant

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Over the past six decades, liver transplantation (LT) has evolved from an experimental procedure into a standardized and life-saving intervention, reshaping the landscape of organ transplantation. Driven by pioneering breakthroughs, technological advancements, and a deepened understanding of immunology, LT has seen remarkable progress. Some of the most notable breakthroughs in the field include advances in immunosuppression, a revised model for end-stage liver disease, and artificial intelligence (AI)-integrated imaging modalities serving diagnostic and therapeutic roles in LT, paired with ever-evolving technological advances. Additionally, the refinement of transplantation procedures, resulting in the introduction of alternative transplantation methods, such as living donor LT, split LT, and the use of marginal grafts, has addressed the challenge of organ shortage. Moreover, precision medicine, guiding personalized immunosuppressive strategies, has significantly improved patient and graft survival rates while addressing emergent issues, such as short-term complications and early allograft dysfunction, leading to a more refined strategy and enhanced post-operative recovery. Looking ahead, ongoing research explores regenerative medicine, diagnostic tools, and AI to optimize organ allocation and post-transplantation car. In summary, the past six decades have marked a transformative journey in LT with a commitment to advancing science, medicine, and patient-centered care, offering hope and extending life to individuals worldwide.

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Effects of a Domino Liver Transplantation Program on Patient Survival and Waiting List Time: A Single-Center Retrospective Study

Cited by 2 publications

References 28 publications

Clinical outcomes after transplantation of domino grafts or standard deceased donor livers: a systematic review and meta‐analysis

Clinical outcomes after transplantation of domino grafts or standard deceased donor livers: a systematic review and meta‐analysis

Lesson learnt from 60 years of liver transplantation: Advancements, challenges, and future directions

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