Pınar SARKUT, Barış GÜLCÜ, Remzi İŞÇİMEN, Murat KIYICI, Gürkan TÜRKER

Early graft dysfunction and mortality rate in marginal donor liver transplantation

To determine the effect of marginal donor livers on mortality and graft survival in liver transplantation (LT) recipients. Materials and methods: Donors with any 1 of following were considered marginal donors: age =>65 years, sodium level =>165 mmol/L and cold ischemia time =>12 h. Donors were classified according to the donor risk index (DRI) 1.7. The transplant recipients' model for end-stage liver disease (MELD) scores were considered low if 20. Early graft dysfunction (EGD) and mortality rate were evaluated. Results: During the study period 47 patients underwent cadaveric LT. The mean age of the donors and recipients was 45 years (range: 5¬-72 years) and 46 years (range: 4-66 years), respectively. In all, there were 15 marginal donors and 18 donors with a DRI >1.7. In total, 4 LT patients that received livers from marginal donors and 5 that received livers from donors with a DRI =>1.7 had EGD. Among the recipients of marginal livers, 5 died, versus 4 of the recipients of standard livers. There was no significant difference in EGD or mortality rate between the patients that received livers from marginal donors or those with a DRI =>1.7 and patients that received standard donor livers. Conclusion: Marginal and DRI =>1.7 donors negatively affected LT outcomes, but not significantly.

Anahtar Kelimeler:

Key words: Marginal donor, cadaveric liver transplantation, early graft dysfunction, mortality

Early graft dysfunction and mortality rate in marginal donor liver transplantation

Keywords:

Key words: Marginal donor, cadaveric liver transplantation, early graft dysfunction, mortality,

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Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology 2000; 31: 864–871.
Feng S, Goodrich NP, Bragg-Gresham JL, Dykstra DM, Punch JD, DebRoy MA, Greenstein SM, Merion RM. Characteristics associated with liver graft failure: the concept of a donor risk index. Am J Transplant 2006; 6: 783–790.
Organ Procurement and Transplantation Network. Available at: www.optn.org. Goldaracena N, Quinonez E, Mendez P, Anders M, Orozco Ganem F, Mastai R, Mc Cormack L. Extremely marginal liver grafts from deceased donors have outcome similar to ideal grafts. Transplant Proc 2012; 44: 2219–2222.
Frühauf NR, Fischer-Fröhlich CL, Kutschmann M, SchmidtmannI, Kirste G. Joint impact of donor and recipient parameters on the outcome of liver transplantation in Germany. Transplant Proc 2011; 92: 1378–1384.
Bonney GK, Aldersley MA, Asthana S, Toogood GJ, Pollard SG, Lodge JP, Prasad KR. Donor risk index and MELD interactions in predicting long-term graft survival: a singlecentre experience. Transplantation 2009; 87: 1858–1863.
Maluf DG, Edwards EB, Kauffman HM. Utilization of extended donor criteria liver allograft: is the elevated risk of failure independent of the Model for End-Stage Liver Disease score of the recipient? Transplantation 2006; 82: 1653–1657.
Amin MG, Wolf MP, Ten Brook JA Jr, Freeman RB Jr, Cheng SJ, Pratt DS, Wong JB. Expanded criteria donor grafts for deceased donor liver transplantation under the MELD system: a decision analysis. Liver Transpl 2004; 10: 1468–1475.