PPCA has historically been considered detrimental to donor quality in LT, but
transplantation of grafts from this group of donors is now routine. Our study aims to evaluate the outcomes associated with use of donors with a history of
PPCA in the pediatric population. This study is a single-center retrospective analysis of all pediatric LTs performed over an 18-year period. Donors and recipients were stratified by the presence and length of donor
PPCA time. Preprocurement donor and post-transplant recipient laboratory values were collected to assess the degree of ischemic liver injury associated with each donor group. Cox regression analysis was used to compare survival. The records for 130 deceased pediatric LT donors and corresponding recipients were reviewed. There were 73 (56%) non-
PPCA donors and 57 (44%)
PPCA donors. Donors that experienced a
PPCA event demonstrated a higher median, pretransplant peak
alanine aminotransferase (ALT) level (P < .001). When comparing post-transplant recipient median ALT levels, donors with any
PPCA had lower median peak ALT (P = .15) and day 3 ALT (P = .43) levels than the non-
PPCA group. Rates of early graft loss did not differ. The
PPCA group with >40 minutes of
ischemia had markedly lower survival at 10 years, but this finding did not reach statistical significance. Liver grafts from donors with or without
PPCA demonstrated no statistically significant differences in function or survival. A history of donor
PPCA alone should not be used as an exclusionary criterion in pediatric
liver transplantation.