title: Liver grafts procured by other transplant teams do not affect posttransplantation outcomes.
abstract: BACKGROUND
  Transplant surgeons have one the riskiest jobs in medicine. Multiple reports have described fatalities involving transplant team members who were traveling to recover organs for transplantation. There are few initiatives to use allografts recovered by local teams. We tested the impact of local organ procurement on posttransplantation survival.
  
  
  METHODS
  This single-center retrospective study included primary deceased-donor liver grafts transplanted under the Model for End-stage Liver Disease system. Multivariate analysis was performed to evaluate whether liver allografts procured outside of the organ procurement organization (OPO) region were related to allograft loss. We also studied posttransplantation survival according to local procurement.
  
  
  RESULTS
  There were 271 transplantations performed with local donors, 19 from other states, and 54 from within our state but outside of our OPO. Recipient demographic data were similar among the groups. There were more male (P = .007), slim (P = .01), and younger (P = .008) donors among allografts from other states (national group). Local or regional donors had brain death more often related to cerebrovascular accidents. National donors had brain death related to trauma (P = .01). Multivariate analysis confirmed that local organ retrieval was not related to posttransplantation survival. Kaplan-Meier curves showed no difference in patient and graft survivals among the groups.
  
  
  CONCLUSIONS
  Local procurement did not affect posttransplantation survival. Liver allografts procured by other teams showed equivalent posttransplantation outcomes. Policies that stimulate the training of local teams to procure liver allografts for distant transplant centers should be launched to increase job safety for transplant surgeons.
authors.affiliation: Liver Transplantation Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. salvalaggio@einstein.br
authors.forename: P R
authors.initials: PR
authors.lastname: Salvalaggio
authors.forename: B H
authors.initials: BH
authors.lastname: Ferraz-Neto
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008107:Liver Diseases / Q000175:diagnosis / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D016016:Proportional Hazards Models; D012111:Residence Characteristics; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000401:mortality; D009927:Tissue and Organ Procurement; D014195:Travel; D016896:Treatment Outcome; D014850:Waiting Lists; D055815:Young Adult