Donor risk factors in orthotopic liver transplant: analysis of the OPTN/UNOS registry.

This study of the United Network for Organ Sharing registry data analyzed reputed donor factors using the post-MELD data and evaluated them further in HCV positive and HCV negative recipients with hepatic cirrhosis to develop a modified DRI (mDRI). We found that HCV negative cirrhotic recipients have generally higher tolerance against inferior qualities of donors than HCV positive cirrhotic patients. In addition, the results revealed the post-MELD prognostic factors that should be considered in the donor procurement processes. The group of "all recipients" and the subset of HCV positive cirrhotic recipients showed a similar set of donor risk factors found to significantly decrease graft survival. For these two groups, an mDRI included death by cerebrovascular accident or stroke, donor age >or=65 years, and donor history of diabetes. Using the mDRI for "all recipients", the 1-year graft survival decreased by 3-4% per additional donor factor present. In HCV positive cirrhotic recipients, the 1-year graft survival decreased by 2-6% per additional donor factor present. In addition, we developed an mDRI for HCV negative cirrhotic recipients comprised of only two donor factors, cytomegalovirus positive donor serostatus and donor age >or=65 years, resulting in a 1-year graft survival of 87.7% for no factors and 83.2% for 2 donor factors. Overall, our findings suggest that by having more refined, thus fewer, donor risk factors, the newly proposed DRI could potentially expand th...
Source: Clinical Transplants - Category: Transplant Surgery Tags: Clin Transpl Source Type: research