{"doi":"10.17615/nxfd-c552","title":"Declining liver utilization for transplantation in the United States and the impact of donation after cardiac death","abstract":"Worsening donor liver quality resulting in decreased organ utilization may be contributing to the recent decline in liver transplants nationally. We sought to examine trends in donor liver utilization and the relationship between donor characteristics and non-use. We used the United Network for Organ Sharing database to review all deceased adult organ donors in the United States who had at least one solid organ transplanted into a recipient. Trends in donor characteristics were examined. Multivariate logistic regression was used to evaluate the association between donor characteristics and liver non-use between 2004 and 2010. Population attributable risk proportions were determined for donor factors associated with non-use. 107,259 organ donors were analyzed. The number of unused livers decreased steadily from 1,958 (66% of donors) in 1988 to 841 (15%) in 2004, but then gradually increased to 1,345 (21%) in 2010. Donor age, body mass index (BMI), and the prevalence of diabetes and donation after cardiac death (DCD) all increased over time, and all four were independently associated with liver non-use. DCD had the highest adjusted odds ratio (OR) for non-use, and the odds increased nearly four-fold between 2004 (OR 5.53; 95% CI, 4.57–6.70) and 2010 (OR 21.31; 95% CI, 18.30–24.81). The proportion of non-use attributable to DCD increased from 9% in 2004 to 28% in 2010. The proportion of donor livers not used has increased since 2004. Older donor age, greater BMI, diabetes, and DCD are all independently associated with non-use and are on the rise nationally. Current trends may lead to significant declines in liver transplant availability.","journal":"UNC Libraries","year":2020,"id":141698,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9608,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":387633,"name":"Stephanie B. Wheeler","orcid":"0000-0002-3399-9047","position":1,"is_corresponding":false},{"id":376446,"name":"Paul H. Hayashi","orcid":"0000-0002-5371-1020","position":2,"is_corresponding":false},{"id":284721,"name":"Eric S. Orman","orcid":"0000-0002-8295-9076","position":3,"is_corresponding":false},{"id":226670,"name":"A. Sidney Barritt","orcid":"0000-0002-4200-3256","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-18T23:17:27.861239Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}