Certification training and liver transplant experience improves liver procurement outcomes: the Dutch approach

BackgroundThis study investigates the impact of certification training and liver transplant experience on procurement outcomes of deceased donor liver procurement in the Netherlands. Methods:Three groups (trainee, certified, and master) were formed, with further subdivision based on liver transplant experience. Three key outcomes—surgical injury, graft discard after injury, and donor hepatectomy duration—were analyzed.Results: There were no significant differences in surgical graft injury in the three groups (trainee, 16.9%; certified, 14.8%; master, 18.2%; P = 0.357; 2011 to 2018). The only predictor for surgical graft injury was donation after circulatory death (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.10-2.02). Of the three groups, the master group had the highest discard rate after surgical injury (trainee, 0%; certified, 1.3%; master, 2.8%; P = 0.013). Master group without liver transplant experience (OR, 3.16; 95% CI, 1.21-8.27) and male donor sex (OR, 3.58; 95% CI, 1.32-9.73) were independent risk factors for discarding livers after surgical injury. Independent predictors for shorter hepatectomy durations included donors older than 50 years (coefficient [Coeff], −7.04; 95% CI, −8.03 to −3.29; P