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The impact of donor factors on the outcomes following liver transplantation

2002; Elsevier BV; Volume: 34; Issue: 5 Linguagem: Inglês

10.1016/s0041-1345(02)02944-5

1873-2623

Joseph F. Buell, David Cronin, L Blahnik, A Lo, C Trimbach, Rick R. Layman, J. Michael Millis,

Liver Disease Diagnosis and Treatment

The outcome of liver transplantation (LTx) has been correlated with several donor and recipient factors.A database of 191 consecutive LTx cases was analyzed using Kaplan–Meier and Cox regression statistics based on 80 variables. To avoid additional effects of late events on patient survival, the chosen endpoint was 6 months. Data were evaluated using SPSS statistical software.Kaplan–Meier analysis revealed a difference in 1- to 6-month graft survival between patients transplanted with organs from donors older versus younger than 60 years (Breslow, P < .01). Differences in 1- to 6-month graft survivals were observed between patients listed as UNOS status 3, 2B, 2A, and 1: the outcomes for UNOS status 2B versus UNOS status 2A and UNOS status 2B versus status 1 were significant (P < .05). Differences in 1- to 6-month graft survival rates were found between patients with versus without sepsis (P < .05), and with versus without rejection episodes (P < .01). Cox regression analysis revealed only three of the variables to be independent prognostic predictors of graft failure: donor age; postoperative septic status; and rejection. The best mathematical multivariate Cox regression model linked donor age + donor Na + rejection + sepsis to 1- to 6-month graft survival (chi-square = 29.06, P < .001).Factors predictive of 1- to 6-month graft survival after liver transplantation include donor age; UNOS status; sepsis; and rejection.