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Risk factors for graft survival after liver transplantation from donation after cardiac death donors: an analysis of OPTN/UNOS data.

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Mateo, R Cho, Y Singh, G Stapfer, M Donovan, J Jabbour, Nicolas [UCL] Genyk, Y

Due to increasing use of allografts from donation after cardiac death (DCD) donors, we evaluated DCD liver transplants and impact of recipient and donor factors on graft survival. Liver transplants from DCD donors reported to UNOS were analyzed against donation after brain death (DBD) donor liver transplants performed between 1996 and 2003. We defined a recipient cumulative relative risk (RCRR) using significant risk factors identified from a Cox regression analysis: age; medical condition at transplantation; regraft status; dialysis received and serum creatinine. Graft survival from DCD donors (71% at 1 year and 60% at 3 years) were significantly inferior to DBD donors (80% at 1 year and 72% at 3 years, p < 0.001). Low-risk recipients (RCRR < or = 1.5) with low-risk DCD livers (DWIT < 30 min and CIT < 10 h, n = 226) achieved graft survival rates (81% and 67% at 1 and 3 years, respectively) not significantly different from recipients with DBD allografts (80% and 72% at 1 and 3 years, respectively, log-rank p = 0.23). Liver allografts from DCD donors may be used to increase the cadaveric donor pool, with favorable graft survival rates achieved when low-risk grafts are transplanted in a low-risk setting. Whether transplantation of these organs in low-risk recipients provides a survival benefit compared to the waiting list is unknown.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2006
Language Anglais
Journal information "American Journal of Transplantation" - Vol. 6, no.4, p. 791-796 (2006)
Peer reviewed yes
Publisher Wiley-Blackwell Publishing, Inc. (Malden)
issn 1600-6135
e-issn 1600-6143
Publication status Publié
Affiliation Keck School of Medicine, Univertisty of Southern California, University Hospital, Los Angeles (USA) - Division of Hepatobiliary/Pancreatic Surgery and Abdominal Organ Transplantation
MESH Subject Cadaver ; Risk Factors ; Tissue Donors ; Tissue and Organ Procurement ; Death ; Female ; Graft Rejection ; Graft Survival ; Humans ; Liver Transplantation ; Male ; Middle Aged
Keywords DCD ; Donation after cardiac death ; Graft survival ; Liver transplantation
Links
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Bibliographic reference Mateo, R ; Cho, Y ; Singh, G ; Stapfer, M ; Donovan, J ; et. al. Risk factors for graft survival after liver transplantation from donation after cardiac death donors: an analysis of OPTN/UNOS data.. In: American Journal of Transplantation, Vol. 6, no.4, p. 791-796 (2006)
Permanent URL http://hdl.handle.net/2078/165214