TY - JOUR
T1 - Characteristics associated with liver graft failure
T2 - The concept of a donor risk index
AU - Feng, S.
AU - Goodrich, N. P.
AU - Bragg-Gresham, J. L.
AU - Dykstra, D. M.
AU - Punch, J. D.
AU - DebRoy, M. A.
AU - Greenstein, S. M.
AU - Merion, R. M.
PY - 2006/4
Y1 - 2006/4
N2 - Transplant physicians and candidates have become increasingly aware that donor characteristics significantly impact liver transplantation outcomes. Although the qualitative effect of individual donor variables are understood, the quantitative risk associated with combinations of characteristics are unclear. Using national data from 1998 to 2002, we developed a quantitative donor risk index. Cox regression models identified seven donor characteristics that independently predicted significantly increased risk of graft failure. Donor age over 40 years (and particularly over 60 years), donation after cardiac death (DCD), and split/partial grafts were strongly associated with graft failure, while African-American race, less height, cerebrovascular accident and 'other' causes of brain death were more modestly but still significantly associated with graft failure. Grafts with an increased donor risk index have been preferentially transplanted into older candidates (>50 years of age) with moderate disease severity (nonstatus 1 with lower model for end-stage liver disease (MELD) scores) and without hepatitis C. Quantitative assessment of the risk of donor liver graft failure using a donor risk index is useful to inform the process of organ acceptance.
AB - Transplant physicians and candidates have become increasingly aware that donor characteristics significantly impact liver transplantation outcomes. Although the qualitative effect of individual donor variables are understood, the quantitative risk associated with combinations of characteristics are unclear. Using national data from 1998 to 2002, we developed a quantitative donor risk index. Cox regression models identified seven donor characteristics that independently predicted significantly increased risk of graft failure. Donor age over 40 years (and particularly over 60 years), donation after cardiac death (DCD), and split/partial grafts were strongly associated with graft failure, while African-American race, less height, cerebrovascular accident and 'other' causes of brain death were more modestly but still significantly associated with graft failure. Grafts with an increased donor risk index have been preferentially transplanted into older candidates (>50 years of age) with moderate disease severity (nonstatus 1 with lower model for end-stage liver disease (MELD) scores) and without hepatitis C. Quantitative assessment of the risk of donor liver graft failure using a donor risk index is useful to inform the process of organ acceptance.
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U2 - 10.1111/j.1600-6143.2006.01242.x
DO - 10.1111/j.1600-6143.2006.01242.x
M3 - Article
C2 - 16539636
AN - SCOPUS:33644747688
SN - 1600-6135
VL - 6
SP - 783
EP - 790
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 4
ER -