Medizinische Universität Graz - Research portal
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SHR Neuro Cancer Cardio Lipid Metab Microb
Hoyer, DP; Paul, A; Gallinat, A; Molmenti, EP; Reinhardt, R; Minor, T; Saner, FH; Canbay, A; Treckmann, JW; Sotiropoulos, GC; Mathé, Z.
Donor information based prediction of early allograft dysfunction and outcome in liver transplantation.
Liver Int. 2015; 35(1):156-163
Doi: 10.1111/liv.12443
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Mathe Zoltan
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- Abstract:
- Poor initial graft function was recently newly defined as early allograft dysfunction (EAD) [Olthoff KM, Kulik L, Samstein B, et al. 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. Six hundred and seventy-eight consecutive adult patients (mean age 51.6 years; 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. 38.7% 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). Early 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. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Age Factors -
- Allografts - physiopathology
- Bilirubin - blood
- Body Mass Index -
- Female -
- Humans -
- Kaplan-Meier Estimate -
- Liver Transplantation - adverse effects
- Liver Transplantation - statistics & numerical data
- Logistic Models -
- Male -
- Middle Aged -
- Organ Dysfunction Scores -
- Predictive Value of Tests -
- Risk Factors -
- Sex Factors -
- Tissue Donors - statistics & numerical data
- Find related publications in this database (Keywords)
- donor risk factors
- early allograft dysfunction
- liver transplantation
- multivariable analysis
- scoring system