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Abstract: TH-PO1146

It's Now or Never: A Retrospective Audit of Patients Suspended from the Deceased Donor Transplant List

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Author

  • Toal, Michael, Belfast City Hospital, Belfast, United Kingdom
Background

The primary purpose was to evaluate the outcomes of patients suspended from the deceased donor renal transplantation list in Northern Ireland. A three year follow-up period was used from October 2015 to December 2018. The primary outcomes measures were to assess the proportion of patients who were alive and had been transplanted by December 2018. Secondary outcomes were to measure the duration patients were suspended, the reasons for this and to examine the relationship between duration and reason for suspension and likelihood of transplantation.

Methods

A list of patients suspended from the deceased donor transplant list on 28thOctober 2015 was obtained from the regional transplant centre in Belfast City Hospital. Regional medical databases were used to extract data on the date of initial listing on the active list, dates of suspensions, reasons for suspensions and outcomes. The end of follow-up period was 10thDecember 2018.

Results

56 patients were identified on the initial deceased donor renal transplant list. 41 patients (73%) were alive at the end of follow-up, 14 (25%) were deceased and 1 (2%) unknown (moved out of region). 30 patients (53%) had received a renal transplant, 25 patients (45%) had not, with 1 (2%) unknown outcome. The three most common causes for suspension were: the patient was medically unfit to undergo transplant surgery, the patient was awaiting a specialist opinion or investigation and suspension on patient request . Mean time suspended was 645 days and from original listing to transplantation was 807 days. In patients suspended for under one year, 11 of 14 patients were transplanted (79%) , however in patients suspended for over one year, only 13 of 34 patients were transplanted (38%). Patients suspended as they were medically unfit had the lowest rate of transplantation (6/20). All patients suspended on patient request, awaiting radiological investigaton or obesity were transplanted (12 patients).

Conclusion

In a three year follow-up period, most patients who had been suspended in October 2015 were alive and had undergone renal transplantation. The fitness of recepients was the most common reason for suspension from the list and is associated with poorer outcomes. Patients suspended for over one year had a significantly lower rate of transplantation. Regular multi-disciplinary review is required to try to minimise the duration of suspensions.