Donor factors predicting recipient survival after liver retransplantation: the retransplant donor risk index.

Published

Journal Article

The use of extended criteria liver donors (ECD) is controversial, especially in the setting of retransplantation. The aims of this study are to investigate the effects of ECD grafts on retransplantation and to develop a predictive mortality index in liver retransplantation based on the previously established donor risk index. The United Network for Organ Sharing (UNOS) liver transplant dataset was analyzed for all adult, non-status 1, liver retransplantations occurring in the United States since February 2002. All donors were categorized for multiple characteristics of ECD, and using multivariate survival models a retransplant donor risk index (ReTxDRI) was developed. A total of 1327 retransplants were analyzed. There were 611 (46%) recipients who received livers with at least one ECD criterion. The use of ECD grafts in recipients with HCV did not incur worse survival than the non-ECD grafts. The addition of the cause of recipient graft failure to the donor risk index formed the ReTxDRI. After adjusting for multiple recipient factors, the ReTxDRI was predictive of overall recipient survival and was a strongly independent predictor of death after retransplantation (HR 2.49, 95% CI 1.89-3.27, p < 0.0001). The use of the ReTxDRI can improve recipient and donor matching and help to optimize posttransplant survival in liver retransplantation.

Full Text

Duke Authors

Cited Authors

  • Northup, PG; Pruett, TL; Kashmer, DM; Argo, CK; Berg, CL; Schmitt, TM

Published Date

  • August 2007

Published In

Volume / Issue

  • 7 / 8

Start / End Page

  • 1984 - 1988

PubMed ID

  • 17617863

Pubmed Central ID

  • 17617863

International Standard Serial Number (ISSN)

  • 1600-6135

Digital Object Identifier (DOI)

  • 10.1111/j.1600-6143.2007.01887.x

Language

  • eng

Conference Location

  • United States