Title

Donor information based prediction of early allograft dysfunction and outcome in liver transplantation

Publication Date

January 2015

Journal Title

Liver International

Abstract

Background & AimsPoor initial graft function was recently newly defined as early allograft dysfunction (EAD) [Olthoff KM, Kulik L, Samstein B, etal. Validation of a current definition of early allograft dysfunction in liver transplant recipients and analysis of risk factors. Liver Transpl 2010; 16: 943]. Aim of this analysis was to evaluate predictive donor information for development of EAD. MethodsSix hundred and seventy-eight consecutive adult patients (mean age 51.6years; 60.3% men) who received a primary liver transplantation (LT) (09/2003-12/2011) were included. Standard donor data were correlated with EAD and outcome by univariable/multivariable logistic regression and Cox proportional hazards to identify prognostic donor factors after adjustment for recipient confounders. Estimates of relevant factors were utilized for construction of a new continuous risk index to develop EAD. Results38.7% patients developed EAD. 30-day survival of grafts with and without EAD was 59.8% and 89.7% (P<0.0001). 30-day survival of patients with and without EAD was 68.5% and 93.1% (P<0.0001) respectively. Donor body mass index (P=0.0112), gGT (P=0.0471), macrosteatosis (P=0.0006) and cold ischaemia time (CIT) (P=0.0031) were predictors of EAD. Internal cross validation showed a high predictive value (c-index=0.622). ConclusionsEarly allograft dysfunction correlates with early results of LT and can be predicted by donor data only. The newly introduced risk index potentially optimizes individual decisions to accept/decline high risk organs. Outcome of these organs might be improved by shortening CIT.

Volume Number

35

Issue Number

1

Pages

156-163

Document Type

Article

Facility

School of Medicine

Primary Department

Surgery

Additional Departments

Medicine

PMID

WOS:000347723300020

DOI

10.1111/liv.12443

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