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Outcome Analysis of Declined Liver Grafts Compared to Acceptable Donor Livers

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Table S1: Outocme analysis after utilization of previously declined liver grafts compared to a low risk cohort of livers primarily accepted at our centre.

Outcome Parameter

Overall Declined

Livers n=206

Declined DBD n=141

Primarily accepted DBD

n=282

Declined DCD n=65

Primarily accepted

DCD n=65

P value

(declined DBD

vs. primarily accepted DBD)

P value (declined

DCD vs. primarily

accepted DCD)

INR day 1 1.6 (1.3-1.88) 1.5 (1.3-1.8) 1.5 (1.2-1.7) 1.6 (1.4-2.0) 1.6 (1.3-1.9) 0.956 0.475 Peak ALT (U/L) 845 (506-1468) 811 (436-1327) 850 (509-1462) 1014 (553-1758) 793 (443-

1551) 0.653 0.403

Hospital Stay (days) 10.5 (7-16) 10 (7-15) 10 (7-14) 11 (7-17) 10 (7-14) 0.298 0.686

RRT (n/%) 43 (20.9%) 27 (19.1%) 46 (16.3%) 16 (24.6%) 13 (20%) 0.4960 0.6740

Highest Complication overall (Clavien Grading), any:

- Grade V - Grade IVb - Grade IVa - Grade IIIb - Grade IIIa - Grade II - Grade I

- No complications

141 (68.4%) 30 (14.6%)

0 46 (22.3%)

6 (2.9%) 29 (14.1%) 27 (13.1%) 5 (2.4%) 65 (31.6%)

97 (68.8%) 21 (14.9%)

0 29 (20.6%)

6 (4.3%) 16 (11.3%) 21 (14.9%) 4 (2.8%) 44 (31.2%)

181 (64.2%) 34 (12.1%)

0 5 (1.8%) 10 (3.55) 53 (18.8%) 72 (25.5%) 7 (2.5%) 101 (35.8%)

44 (67.7%) 7 (10.8%)

0 17 (26.2%)

0 13 (20%)

6 (9.2%) 1 (1.5%) 21 (32.2%)

55 (84.5%) 9 (13.8%)

0 12 (18.5%)

6 (9.2%) 21 (32.3%)

7 (10.7%) 0 10 (15.4%)

0.3852 0.4444 1.000 0.0001 0.7890 0.0519 0.0129 1.000 0.3852

0.0385 0.7903 1.000 0.3997 0.0277 0.1619 1.000 1.000 0.0385 Cause of Early Graft loss

(n/%):

- PNF - HAT

- Bleeding from conduit - Hemorrhagic necrosis - Veno-venous occlusion - PVT

- Sepsis

Cause of Late graft loss (n/%):

- HAT

- Ischemic cholangiopathy - Tumour recurrence - New Tumour occurrence - Chronic rejection

Other causes (Patient death) - Intracranial bleeding - Cardivascular events

5 (2.4%) 3 (1.5%) 1 (0.5%) 2 (1%) 1 (0.5%)

0 2 (1%) 3 (1.5%)

2 (1%) 4 (1.9%) 3 (1.5%)

0 8 (3.9%)

2 (1%) 6 (2.9%)

4 (2.8%) 0 1 (0.7%) 2 (1.4%) 1 (0.7%)

0 2 (1.4%) 3 (2.1%) 1 (0.7%) 3 (2.1%) 2 (1.4%)

0 8 (5.7%) 2 (1.4%) 6 (4.3%)

5 (1.8%) 6 (3.5%)

0 1 (0.4%) 1 (0.4%) 1 (0.4%) 5 (1.8%) 4 (1.4%) 1 (0.4%) 3 (1.1%) 3 (1.1%) 3 (1.1%) 11 (3.9%)

2 (0.7%) 2 (0.7%)

1 (1.5%) 3 (4.6%)

0 0 0 0 0 0 1 (1.5%) 1 (1.5%) 1 (1.5%)

0 0 0 0

1 (1.5%) 2 (3.1%) 1 (1.5%)

0 0 0 0 1 (1.5%) 2 (3.1%) 1 (1.5%) 1 (1.5%)

0 0 0 0

0.4890 0.1848 0.3333 0.2587 1.000 1.000 1.000 0.6905

1.000 0.4051

1.000 0.5540 0.4574 0.6035 0.0187

1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000

Retransplantation (n/%) 8 (3.9%) 6 (4.3%) 15 (5.3%) 2 (3.1%) 3 (4.6%) 0.8132 0.1848

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2 Data presented as median and IQR or frequency in n/%, INR: International Normalized Ratio; ALT: Amino-Alanine-Transferase; RRT: Renal Replacement Therapy; PNF: Primary-Non- Function; HAT: Hepatic Artery Thrombosis; PVT: Portal Vein Thrombosis;

Figure S1: Graft and Patient survival comparing different causes of initial graft refusal.

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