Geographic variation in utilization of deceased donor livers in the United States in the era of advanced perfusion.

ABSTRACT: Understanding the geographic variation in deceased donor liver utilization can guide allocation policy and technology implementation. Using US transplant registry data, we evaluated geographic differences in utilization by donor quality, policy era, and uptake of advanced perfusion (AP). This retrospective cohort included all liver donors and waitlisted patients from 2010 to Sept. 2024. Donors were aggregated by Hospital Referral Region (HRR) and stratified by quality using the liver discard risk index (DSRI). Exposures included allocation policy era and increased use of AP technology (July 2022-onward). Observed to expected (O:E) ratios of liver non-utilization were calculated by HRR and modeled to reveal geographically contiguous Low Utilization Clusters (LUCs). The proportion of HRRs wi

SUBMITTER: Jones-Carr ME 

PROVIDER: S-EPMC12327723 | biostudies-literature | 2025 Jul

REPOSITORIES: biostudies-literature