The difficulty in defining extended donor criteria for liver grafts: The Eurotransplant experience Journal Article

Authors: Silberhumer, G. R.; Rahmel, A.; Karam, V.; Gonen, M.; Gyoeri, G.; Kern, B.; Adam, R.; Muehlbacher, F.; Rogiers, X.; Burroughs, A. K.; Berlakovich, G. A.
Article Title: The difficulty in defining extended donor criteria for liver grafts: The Eurotransplant experience
Abstract: Donor criteria for liver grafts have been expanded because of organ shortage. Currently, no exact definitions for extended donor grafts have been established. The aim of this study was to analyze the impact of donor-specific risk factors, independent of recipient characteristics. In collaboration with Eurotransplant and European Liver Transplant Register, solely donor-specific parameters were correlated with 1-year survival following liver transplantation. Analyses of 4701 donors between 2000 and 2005 resulted in the development of a nomogram to estimate graft survival for available grafts. Predictions by nomogram were compared to those by Donor Risk Index (DRI). In the multivariate analysis, cold ischemic time (CIT), highest sodium, cause of donor death, γ-glutamyl transferase (γ-GT), and donor sex (female) were statistically significant factors for 3 months; CIT, γ-GT, and cause of donor death for 12-month survival. The median DRI of this study population was 1.45 (Q1: 1.17; Q3: 1.67). The agreement between the nomogram and DRI was weak (kappa = 0.23). Several donor-specific risk factors were identified for early survival after liver transplantation. The provided nomogram will support quick organ quality assessment. Nevertheless, this study showed the difficulties of determining an exact definition of extended criteria donors. © 2013 Steunstichting ESOT.
Keywords: adult; major clinical study; liver transplantation; quality control; prediction; risk factor; cold ischemia; graft survival; gamma glutamyltransferase; nomogram; organ donor; liver graft; donor evaluation; extended liver donor criteria; organ quality
Journal Title: Transplant International
Volume: 26
Issue: 10
ISSN: 0934-0874
Publisher: Steunstichting Esot  
Date Published: 2013-10-01
Start Page: 990
End Page: 998
Language: English
DOI: 10.1111/tri.12156
PROVIDER: scopus
PUBMED: 23931659
Notes: --- - "Export Date: 1 November 2013" - "CODEN: TRINE" - "Source: Scopus"
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MSK Authors
  1. Mithat Gonen
    701 Gonen