Donor risk index predicts graft failure reliably but not post-transplant infections.

Published

Journal Article

BACKGROUND: The Donor Risk Index (DRI) is used to predict graft survival following liver transplantation, but has not been used to predict post-operative infections in graft recipients. We hypothesized that lower-quality grafts would result in more frequent infectious complications. METHODS: Using a prospectively collected infection data set, we matched liver transplant recipients (and the respective allograft DRI scores) with their specific post-transplant infectious complications. All transplant recipients were organized by DRI score and divided into groups with low-DRI and high-DRI scores. RESULTS: We identified 378 liver transplants, with 189 recipients each in the low-DRI and high-DRI groups. The mean DRI scores for the low- and high-DRI-score groups were 1.14±0.01 and 1.74±0.02, respectively (p<0.0001 for the difference). The mean Model for End-Stage Liver Disease (MELD) scores were 26.25±0.53 and 24.76±0.55, respectively (p=0.052), and the mean number of infectious complications per patient were 1.60±0.19 and 1.94±0.24, respectively (p=0.26). Logistic regression showed only length of hospital stay and a history of vascular disease as being associated independently with infection, with a trend toward significance for MELD score (p=0.13). CONCLUSION: We conclude that although DRI score predicts graft-liver survival, infectious complications depend more heavily on recipient factors.

Full Text

Duke Authors

Cited Authors

  • Rosenberger, LH; Gillen, JR; Hranjec, T; Stokes, JB; Brayman, KL; Kumer, SC; Schmitt, TM; Sawyer, RG

Published Date

  • April 2014

Published In

Volume / Issue

  • 15 / 2

Start / End Page

  • 94 - 98

PubMed ID

  • 24283760

Pubmed Central ID

  • 24283760

Electronic International Standard Serial Number (EISSN)

  • 1557-8674

Digital Object Identifier (DOI)

  • 10.1089/sur.2013.035

Language

  • eng

Conference Location

  • United States