Presentation is loading. Please wait.

Presentation is loading. Please wait.

David C. Mulligan, MD, FACS

Published byLiliana Lewis Modified over 9 years ago

Similar presentations

Presentation on theme: "David C. Mulligan, MD, FACS"— Presentation transcript:

1 Outcomes of Abdominal Organ Transplantation Using Custodial HTK Preservation Solution
David C. Mulligan, MD, FACS Chair, Transplant, Hepatobiliary & Pancreatic Surgery Professor of Surgery, Mayo Clinic School of Medicine Mayo Clinic Arizona

2 Mayo Clinic Largest Transplant Entity in U.S.
1469 Total Transplants in 2006 717 446 306

3 Mayo Clinic Data 2007

4 MCA Abdominal Organ Transplant History Then and Now
Liver Transplant Program Deceased Donor Liver Transplantation (1999) 2007 – 33rd out of 127 programs in US Living Donor Liver Program (2001) – 1st in AZ 2006 – 7th largest in the US 2007 – 5th largest out of 71 programs Kidney Transplant Program 2007 – 22nd largest out of 245 programs overall Living Donor Kidney Program (1999) 2006 – 15th largest in the US 2007 – 12th largest out of 245 programs Laparoscopic Donor Procedure (1999) First in the Foundation & Arizona Pancreas Transplant Program November 2002 UNOS Certified First K/P Transplant in July 2003 2007 – 3rd largest not factoring pancreas alone

5 MCA Liver Transplantation Program
1999 to 2007 Volume Data Liver Transplants - 411 Living Donor Transplants - 77 (19%) 2007 Volume Data Liver Transplants - 66 13 of 66 Transplants - Living Donor 2006 Outcome Data* 1 Year Patient Survival 91.85% Actual vs % National Avg (Combined) 1 Year Graft Survival 89.41% Actual vs % National Avg (Combined) * SRTR National Data Base - January 2007 Release

6 Mayo System and National Comparison % 1 Year Patient and Graft Survival
SRTR National Data Base - January Release Deceased Donor Only for Appropriate Comparison

7 Mayo System and National Comparison Median Length of Stay Post Transplant
SRTR National Data Base - January 2007 Release Median LOS for Deceased Donor

8 Liver Waitlist & Transplants 2001 - 2007
Wait List Size as of Last Day of Year

9 Etiology of Liver Disease
* Liver disease transplanted Q1 2007 Q1 2007

10 Cold Ischemia Time (hours) Cumulative
Average CIT hrs Median CIT hrs Range hrs Q1 2007

11 Benchmarking: National Centers of Excellence UNOS Patient Survival Data (1/01/04 - 6/30/06 w/ 1 Mo. & 1 Yr. Cohorts; 01/01/01 - 6/30/03 w/ 3 Yr. Cohort) Q4 2007

12 Benchmarking: National Centers of Excellence UNOS Graft Survival Data (1/01/04 - 6/30/06 w/ 1 Mo. & 1 Yr. Cohorts; 7/01/01 – 12/31/03 w/ 3 Yr. Cohort) Q4 2007

13 Kidney / Pancreas Transplant Program 2007

14 MCA Kidney Transplantation Program
1999 to 2007 Volume Data Kidney Transplants - 890 Living Donor Kidney Transplants (51%) Pancreas Transplants - 70 2007 Volume Data Kidney Transplants - 185 Living Donor Kidney Transplants - 88 (51%) Pancreas Transplants - 30 2006 Outcome Data Kidney Transplant* 1 Year Patient Survival 96.13% Actual vs % Expected 1 Year Graft Survival 92.83% Actual vs % Expected * SRTR National Data Base - January 2007 Release Combined Living and Deceased Donor Transplants

15 Mayo System and National Comparison % 1 Year Patient and Graft Survival
* SRTR National Data Base - January 2007 Release Combined Living and Deceased Donor Transplants

16 Mayo System and National Comparison Length of Stay - Time on Wait List
SRTR National Data Base - January 2007 Release LOS for Deceased Donor, Wait Times Includes Both Living and Deceased Donor Transplants

17 Kidney Waitlist & Transplants 2001 - 2007
Wait List Size as of Last Day of Year

18 Donor Source (N=654) Cumulative
Living Related Donor 238 Living Unrelated Donor 154 Deceased Donor Q1 2007

19 Pancreas Transplantation at MCA

20 Pancreas Transplants at MCA by type of transplant

21 Type of Surgical Procedure

22 MCH Patient/Graft Survival for KP Txs (Kaplan-Meier)

23 MCH Patient/Graft Survival for PAK & PTA (Kaplan-Meier)

24 Immunosuppression Thymoglobulin Prograf MMF Long-term steroids Campath
Rapid steroid taper

25 Acute Rejection during the first year
Kidney-Pancreas : 17% Solitary Pancreas: 32%

26 Kidney-Pancreas : Steroid Avoidance
37 patients Patient survival 100% Graft Survival Kidney 97% Pancreas 95% Acute Rejection 11%

27 Pancreas Experience with HTK (n=100)
Mean CIT = 9.6hrs (4hrs – 22.9hrs) Less than 12hrs – 77% 12 to 15.9hrs – 18% Greater than 16hrs – 5% No cases of graft pancreatitis or vascular thrombosis due to preservation

28 Historical Total Transplant Volumes 2001 to present

29 Conclusions Strong clinical academic solid organ transplant practice with complete conversion from UW to Custodial HTK in 2003 without any negative effect Improved outcomes using Custodial for Living Donor Liver Transplantation Recommendation for HTK for DCD donors to improve outcomes

Download ppt "David C. Mulligan, MD, FACS"

Similar presentations

Liver Transplant Outcomes in the United States : Effect of Preservation Solution DKFC Symposium July 16, 2012 John Fung, MD, PhD Cleveland Clinic Disclosure:

Liver Transplant Outcomes in the United States : Effect of Preservation Solution DKFC Symposium July 16, 2012 John Fung, MD, PhD Cleveland Clinic Disclosure:
Ken Andreoni, MD Chair UNOS Kidney Comm The Ohio State University

Ken Andreoni, MD Chair UNOS Kidney Comm The Ohio State University
UNOS Region 8 MELD29 Trial Analysis of the Results

UNOS Region 8 MELD29 Trial Analysis of the Results
SRTR Transplant Benefit-Based Liver Allocation Robert M. Merion, MD, FACS OPTN/UNOS Liver Forum Atlanta, GA April 12, 2010.

SRTR Transplant Benefit-Based Liver Allocation Robert M. Merion, MD, FACS OPTN/UNOS Liver Forum Atlanta, GA April 12, 2010.
Basics of Organ Transplantation Lon Eskind, MD Director Liver Transplant, CMC Assoc. Medical Director of LifeShare.

Basics of Organ Transplantation Lon Eskind, MD Director Liver Transplant, CMC Assoc. Medical Director of LifeShare.
Concentric Circle Liver Distribution Models

Concentric Circle Liver Distribution Models
KAREN L. WALKER MS JONATHAN J. SHUSTER PHD THOMAS M. BEAVER MD, MPH DIVISION OF THORACIC AND CARDIOVASCULAR SURGERY DIVISION OF BIOSTATISTICS UNIVERSITY.

KAREN L. WALKER MS JONATHAN J. SHUSTER PHD THOMAS M. BEAVER MD, MPH DIVISION OF THORACIC AND CARDIOVASCULAR SURGERY DIVISION OF BIOSTATISTICS UNIVERSITY.
1 Abdominal Organ Transplant Program Mayo Clinic Arizona 2006 Review Annual Report to CPC / Board of Governors David D. Douglas, MD Raymond L. Heilman,

1 Abdominal Organ Transplant Program Mayo Clinic Arizona 2006 Review Annual Report to CPC / Board of Governors David D. Douglas, MD Raymond L. Heilman,
Northwestern University Feinberg School of Medicine New Trends in organ donation and Transplantation Juan Carlos Caicedo, MD FACS Director, Hispanic Transplant.

Northwestern University Feinberg School of Medicine New Trends in organ donation and Transplantation Juan Carlos Caicedo, MD FACS Director, Hispanic Transplant.
Patricia A. Sheiner, M.D. President, New York Center for Liver Transplantation Director, Liver Transplantation, Westchester Medical Center 1.

Patricia A. Sheiner, M.D. President, New York Center for Liver Transplantation Director, Liver Transplantation, Westchester Medical Center 1.
Issues In Organ Donation. The Data As of 10/6/09 there are 104,043 people on the US waiting list From January to July of 2009 16,677 transplants were.

Issues In Organ Donation. The Data As of 10/6/09 there are 104,043 people on the US waiting list From January to July of ,677 transplants were.
Superior outcomes in HIV-positive kidney transplant patients compared to HCV-infected or HIV/HCV co-infected recipients Deirdre Sawinski MD, Kimberly A.

Superior outcomes in HIV-positive kidney transplant patients compared to HCV-infected or HIV/HCV co-infected recipients Deirdre Sawinski MD, Kimberly A.
What makes a pancreas allograft marginal? Peter J Friend University of Oxford.

What makes a pancreas allograft marginal? Peter J Friend University of Oxford.
Donor Utilization: Making Use of a Precious Resource in Cardiac Transplant Jason W. Smith, MD Assistant Professor of Surgery The University of Washington.

Donor Utilization: Making Use of a Precious Resource in Cardiac Transplant Jason W. Smith, MD Assistant Professor of Surgery The University of Washington.
Kidney Transplantation An Overview

Kidney Transplantation An Overview
BACKGROUND ON PANCREAS HISTOLOGICAL FINDINGS: University of Maryland experience John C. Papadimitriou, M.D.,Ph.D. Professor of Pathology.

BACKGROUND ON PANCREAS HISTOLOGICAL FINDINGS: University of Maryland experience John C. Papadimitriou, M.D.,Ph.D. Professor of Pathology.
Transplant Kidneys Sooner Discard Kidneys Less Francis L. Delmonico, M.D., F.A.C.S. Professor of Surgery, Harvard Medical School Director, Renal Transplantation.

Transplant Kidneys Sooner Discard Kidneys Less Francis L. Delmonico, M.D., F.A.C.S. Professor of Surgery, Harvard Medical School Director, Renal Transplantation.
Lung Transplantation: What? Who? When? Marshall I. Hertz, MD University of Minnesota Medical School and Fairview-University Medical Center Medical Director,

Lung Transplantation: What? Who? When? Marshall I. Hertz, MD University of Minnesota Medical School and Fairview-University Medical Center Medical Director,
ELTR 12/2008 The Present Evolution of Liver Transplantation 1. General evolution of LT in Europe 2. Donor data 3. Recipient data 4. Indications and results.

ELTR 12/2008 The Present Evolution of Liver Transplantation 1. General evolution of LT in Europe 2. Donor data 3. Recipient data 4. Indications and results.
The Recipient Experience Jaime Myers, RN, MSN, CCTC April 29, 2011.

The Recipient Experience Jaime Myers, RN, MSN, CCTC April 29, 2011.

Similar presentations

Ads by Google