Effect of airplane transport of donor livers on post-liver transplantation survival

Table 1 Patient characteristics

Characteristics	Local liver transport (n = 193)	Airplane liver transport (n = 93)	P value
Donor characteristics
Age (yr)	41 (16.8)	44 (14.8)	0.23
Gender-male/female	55%/45%	56%/44%	0.87
Height (cm)	171 (11.5)	172 (9.3)	0.74
Weight (kg)	77 (17.4)	77 (13.4)	0.96
BMI	26 (7.5)	26 (4.2)	0.66
Bilirubin (μmol/L)	15 (8.1)	14 (9.0)	0.38
ALP (U/L)	78 (35.4)	80 (35.8)	0.73
AST (U/L)	70 (84.9)	62 (69.2)	0.52
ALT (U/L)	84 (167.6)	45 (45.8)	0.035
Smoker	63%	64%	0.94
Etoh drinker	82%	69%	0.07
CMV positive	57%	63%	0.421
Cause of Death - trauma/ cerebrovascular accident/anoxia/other	37%/52% /9%/2%	25%/67% /7%/1%	0.129
Donor risk index	1.42 (0.35)	1.88 (0.43)	< 0.0001
Recipient characteristics
Age (yr)	50 (10.8)	47 (13.4)	0.019
Gender-male/female	72%/28%	63%/37%	0.175
Non-Caucasian	19%	22%	0.53
MELD score	14.5 (7.7)	18.2 (10.2)	0.0007
Height (cm)	171 (9.7)	171 (8.2)	0.65
Weight (kg)	78 (15.7)	75 (16.2)	0.08
BMI	27 (4.5)	26 (4.7)	0.21
CMV positive	61%	65%	0.58
Transplant indication	2.6%/97.4%	16.1%/83.9%	< 0.001
Acute liver failure/ chronic liver disease
Transplant factors
CIT (h)	6.4 (2.8)	10.1 (2.9)	< 0.001
ABO incompatible	3.4%	3.8%	1.00

Age, height, weight, BMI, bilirubin, ALP, AST, ALT, MELD score, cold ischemia time and donor risk index were expressed as mean (standard deviation). Other variables were expressed as percentage. Donor allocation, gender, recipient age, gender, transplant indication was available in all patients, Missing data count: donor factors: age: 1; BMI: 50; Bilirubin: 51; ALP: 58; AST: 110; ALT: 54; Smoking history: 113; Drinking history: 107; CMV infection: 19; Cause of death: 24; Donor risk index: 54; Recipient factors: race: 6; MELD score: 5; BMI: 28; CMV infection: 20; Transplantation factors: CIT: 3; Blood type: 27.

Table 2 Predictors for patient survival and graft survival

Factors	HR, 95%CI, P value
	Patient death		Graft loss
	Univariate	Multivariate	Univariate	Multivariate
Cold ischemic time	1.07 (1.002-1.14)	1.04 (0.96-1.13)	1.07 (1.01-1.14)	1.04 (0.96-1.11)
	P = 0.041	P = 0.300	P = 0.018	P = 0.348
Airplane transport liver vs local liver	1.95 (1.25-3.04)	1.86 (1.07-3.22)	2.03 (1.35-3.05)	1.98 (1.20-3.27)
	P = 0.003	P = 0.027	P = 0.001	P = 0.008

Donor age, donor gender, recipient age, recipient gender, cold ischemic time, transplant indication and donor liver transport were included in multivariate analysis.

Table 3 Cause of graft loss within one year and primary graft dysfunction rate n (%)

	Local liver transport (n = 22)	Airplane liver transport (n = 26)	P value
Cause of graft loss			0.027
Primary graft non-function	1 (4.6)	3 (11.5)
Early graft failure	0 (0)	5 (19.3)
MOF due to sepsis	5 (22.7)	9 (34.6)
others	16 (72.7)	9 (34.6)
Primary graft dysfunction	1 (4.6)	10 (38.5)	0.006

MOF: Multi-organ failure.