Analysis of declined liver allografts reveals outcomes in adult recipients, suggesting insights for better transplantation practices.
Background Few studies have evaluated allografts that were declined before the acceptance for deceased‐donor liver transplantation. We aimed to elucidate the characteristics of these allografts and assess their transplantation outcomes. Methods We analyzed data from 730 adult liver allografts transplanted between July 2010 and March 2024. Clinical characteristics of the transplanted allografts were evaluated according to the number of declines, and the outcomes of the recipients were analyzed. Results Transplanted allografts were categorized into three groups: ≥ 5 declined ( n = 41), 1–4 declined ( n = 104), and no declined group ( n = 585). The ≥ 5 declined group exhibited high liver enzyme levels and steatosis. Within this group, the Japan Risk Index and total ischemic time (TIT) were identified as poor prognostic factors. Notably, in cases where TIT exceeded 10 h, a poor prognosis was observed in the ≥ 5 declined group. Conclusion Abnormal liver functions or steatosis were observed in the ≥ 5 declined group. Shortening the TIT could contribute to an improved prognosis after transplantation.
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Mita et al. (2025) studied this question.
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