Open AccessThe difficulty in defining extended donor criteria for liver grafts: the Eurotransplant experience
Author(s) -
Silberhumer Gerd R.,
Rahmel Axel,
Karam Vincent,
Gonen Mithat,
Gyoeri Georg,
Kern Barbara,
Adam Rene,
Muehlbacher Ferdinand,
Rogiers Xavier,
Burroughs Andrew K.,
Berlakovich Gabriela A.
Publication year - 2013
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12156
Subject(s) - nomogram , medicine , liver transplantation , economic shortage , multivariate analysis , population , living donor liver transplantation , surgery , transplantation , urology , waiting list , environmental health , linguistics , philosophy , government (linguistics)
Summary Donor criteria for liver grafts have been expanded because of organ shortage. Currently, no exact definitions for extended donor grafts have been established. The aim of this study was to analyze the impact of donor‐specific risk factors, independent of recipient characteristics. In collaboration with Eurotransplant and European Liver Transplant Register, solely donor‐specific parameters were correlated with 1‐year survival following liver transplantation. Analyses of 4701 donors between 2000 and 2005 resulted in the development of a nomogram to estimate graft survival for available grafts. Predictions by nomogram were compared to those by Donor Risk Index ( DRI ). In the multivariate analysis, cold ischemic time ( CIT ), highest sodium, cause of donor death, γ‐glutamyl transferase (γ‐ GT ), and donor sex (female) were statistically significant factors for 3 months; CIT , γ‐ GT , and cause of donor death for 12‐month survival. The median DRI of this study population was 1.45 (Q1: 1.17; Q3: 1.67). The agreement between the nomogram and DRI was weak (kappa = 0.23). Several donor‐specific risk factors were identified for early survival after liver transplantation. The provided nomogram will support quick organ quality assessment. Nevertheless, this study showed the difficulties of determining an exact definition of extended criteria donors.