1. LOMR Portal Project Chris Marsh MD, FACS, Project Lead
Heather Neil, Research Project Leader UNOS Research Department
Jamie Case, Research Scientist Scripps
Ann M. Harper, MPH
15 March 2017

2. LOMR Portal Project
Purpose: advancement of usage of ECD/DCD levers in region 5
Who: region 5 liver programs
What: TransQIP light for post op liver transplant outcomes
Next steps ;
Commitment of Centers-sign off on participation agreement
IRB needed by center practice and future publications
Build out of portal and testing: April
Data entry: retrospective for 6 months: kick off May
Go forward for 2 years ( and beyond?)
Share best practices
DMG data to improve donor selection

3. Adult Recipients of Deceased Donor Liver Transplants, Potential Participants in Region 5 January 1, December 31, 2016
Txp Centers who indicated support
ECD/DCD/SDC
Total
DCD
ECD
SCD N %
AZMC: Mayo Clinic Hospital 40
33.1 26
21.5 55
45.5
121
CACS: Cedars-Sinai Medical Center 21
26.6 58
73.4 79
CAGH: Scripps Green Hospital 4
11.8 30
88.2 34
CAPM: California Pacific Medical Center 5
8.3 16
26.7 39
65.0 60
CASF: Univ of California San Francisco Medical Center
11.1
18.1
102
70.8
144
CASU-TX1: Stanford Health Care 3
5.0 11
18.3 46
76.7
CAUC: Univ of California at Los Angeles Medical Center 6
4.0 17
11.3
128
84.8
151
CAUH Keck Hospital of USC
17.7
82.3 96 67
9.8
127
18.5
491
71.7
685

4. Adult Recipients of Deceased Donor Liver Transplants, Potential Participants in Region 5 January 1, December 31, 2016
Txp Centers who indicated support
Macro Fat > 20%
DRI > 1.8 N %
AZMC: Mayo Clinic Hospital 23
19.0 59
48.8
CACS: Cedars-Sinai Medical Center 2
2.5 18
22.8
CAGH: Scripps Green Hospital
5.9 4
11.8
CAPM: California Pacific Medical Center 3
5.0 14
23.3
CASF: Univ of California San Francisco Medical Center 6
4.2 34
23.6
CASU-TX1: Stanford Health Care 5
8.3
10.0
CAUC: Univ of California at Los Angeles Medical Center
1.3 16
10.6
CAUH Keck Hospital of USC
3.1
16.7
Total 41
6.0
161
23.5

5. Adult Recipients of Deceased Donor Liver Transplants, Select Programs in Region 5 (LOMR), January 1, December 31, 2016
Type
Variable N
Mean
Median
DCD
Total Cold Ischemic Time (Hours) Length of Post-tx Hospitalization M/P Lab score DRI DDR (LI) Macro Fat (%)
ECD
Total Cold Ischemic Time (Hours) Length Of Post-tx Hospitalization M/P Lab score DRI DDR (LI) Macro Fat (%)
SCD

6. Adult Recipients of Deceased Donor Liver Transplants, Select Programs in Region 5 (LOMR), January 1, December 31, 2016
Macro Fat > 20%
Variable N
Mean
Median No
Total Cold Ischemic Time (Hours) Length Of Post-Tx Hospitalization M/P Lab score
Yes
DRI > 1.8 No
Total Cold Ischemic Time (Hours) Length Of Post-Tx Hospitalization M/P Lab score
Yes

7. Adult Recipients of Deceased Donor Liver Transplants, Select Programs in Region 5 (LOMR), January 1, December 31, 2016
M/P Lab Score 35+ N
Mean
Median No
Total Cold Ischemic Time (Hours) Length Of Post-Tx Hospitalization
Yes

8. Adult Recipients of Deceased Donor Liver Transplants, Select Programs in Region 5 (LOMR), January 1, December 31, 2016
Share
Type
DCD
ECD
SCD
Total N %
Local 23
6.9 78
23.4
233
69.8
334 47
11.4 60
14.6
304
74.0
411 70
9.4
138
18.5
537
72.1
745

9. DRAFT Registry Variables – Populated from UNet℠
Transplant Hospital Code
Recipient BMI at Transplant
Date of Procedure
Recipient Identification Number (UNOS PX ID)
Recipient Diabetes Mellitus at Listing
Cold Ischemia Time
UNOS Donor ID
Functional Health Status at TRR
Multi-organ Transplant
Donor Age
Dialysis At Least Twice in the Prior Week
Graft Type
Allocation Type
Recipient Blood Type
Length of Initial Hospital Stay
Donor Gender
Serum Creatinine at Transplant
Graft Loss at Discharge
Donor Ethnicity
Total Bilirubin at Transplant
Death at Discharge
Donor Height
INR at Transplant
Graft Loss at 90 Days
Donor Weight
Calculated MELD score at Transplant
Death at 90 Days
Donor Cause of Death
Recipient Medical Condition at Transplant
Death ( days)
Donor Cause of Death, Other Specify
Pathology Confirmed Diagnosis
Reason(s) for Graft Loss
% Macro Vesicular Fat
Text of Pathology Confirmed Diagnosis
Recipient Primary Cause of Death
Was this donor recovered under DCD protocol
Exception Case at Transplant
Recipient Contributory Causes of Death
Donor ABO
Allocation MELD/PELD or Status at Transplant
Recipient date of Birth
Recipient Portal Vein Thrombosis at Transplant
Recipient Primary Cause of Death - Other Specify Text
Recipient Gender
Recipient History of Malignancy at Listing
Recipient Contributory Cause of Death 1 - Other Specify Text
Recipient Ethnicity
Recipient Ever Hepatocellular Carcinoma (HCC) Diagnosis?
Recipient Contributory Cause of Death 2 - Other Specify Text
Highest Education Level at Listing
Recipient (TIPS) at Transplant
Donor Length of Hospital Stay
Employment Status at Transplant
Recipient Prior Abdominal Surgery at Listing
Warm Ischemia Time
Recipient had a Prior Liver Transplant Procedure
Recipient Prior Abdominal Surgery at Transplant
Recipient Height (cm) at Transplant
History of Spontaneous Bacterial Peritonitis (SBP) at Listing
Recipient Weight (kg) at Transplant

10. DRAFT Registry Variables – Entered by Centers
Recipient Hypertension
Total number of Post-Procedural ICU days
Current Smoker within One Year
On Ventilator > 48 Hours
Recipient Recent Infection
Intraoperative or Postoperative Cardiac Arrest Requiring CPR
Urinary Tract
Portal Vein Thrombosis/Stenosis requiring Therapy
Pneumonia
Hepatic Artery Stenosis/Thrombosis requiring Therapy
Bacteremia
Biliary Stricture requiring Intervention
Cholangitis
Biliary Leak requiring Intervention
SBP
Hospital Readmission Within 30 Days
Soft Tissue
Return to the OR within 30 days
Other
Biliary Stricture requiring intervention within 90 Days
Other Specify Text
Initiation of postoperative dialysis within 90 days
WBC at Transplant
Reoperation within 90 Days
AST at Transplant
Re Intervention-performed IR, procedural room within 90 days
ALT at Transplant
Hospital Readmission within 90 Days
Recipient intubated at time of transplant
Biliary Stricture ( days)
Biliary Stent Present at Transplant
Graft Loss ( days)
Biliary Anastomosis
Hospital Readmission ( days)
Portal Vein Reconstruction/Graft Type
Reoperation ( days)
Hepatic Artery Reconstruction/Bypass
Return to the OR ( days)
PRBC Units - Incision to 12 hours post-op
Re Intervention-performed IR, procedural room ( days)
PRBC Units - 12 to 72 hours post-op
FFP Units - Incision to 12 hours post-op

11. LOMR Registry Prototype – Registration Form

12. LOMR Registry Prototype – 30 Day Post-Op Form

13. LOMR Registry Prototype – 90 Day Follow-Up Form

14. LOMR Registry Prototype – 1 Yr Follow-Up Form