Risk factors for graft survival after liver transplantation from donation after cardiac death donors: An analysis of OPTN/UNOS data

R. Mateo*, Y. Cho, G. Singh, M. Stapfer, J. Donovan, J. Kahn, T. L. Fong, L. Sher, N. Jabbour, S. Aswad, R. R. Selby, Y. Genyk

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

234 Scopus citations

Abstract

Due to increasing use of allografts from donation after cardiac death (DCD) donors, we evaluated DCD liver transplants and impact of recipient and donor factors on graft survival. Liver transplants from DCD donors reported to UNOS were analyzed against donation after brain death (DBD) donor liver transplants performed between 1996 and 2003. We defined a recipient cumulative relative risk (RCRR) using significant risk factors identified from a Cox regression analysis: age; medical condition at transplantation; regraft status; dialysis received and serum creatinine. Graft survival from DCD donors (71% at 1 year and 60% at 3 years) were significantly inferior to DBD donors (80% at 1 year and 72% at 3 years, p < 0.001). Low-risk recipients (RCRR ≤ 1.5) with low-risk DCD livers (DWIT < 30 min and CIT < 10 h, n = 226) achieved graft survival rates (81% and 67% at 1 and 3 years, respectively) not significantly different from recipients with DBD allografts (80% and 72% at 1 and 3 years, respectively, log-rank p = 0.23). Liver allografts from DCD donors may be used to increase the cadaveric donor pool, with favorable graft survival rates achieved when low-risk grafts are transplanted in a low-risk setting. Whether transplantation of these organs in low-risk recipients provides a survival benefit compared to the waiting list is unknown.

Original languageEnglish
Pages (from-to)791-796
Number of pages6
JournalAmerican Journal of Transplantation
Volume6
Issue number4
DOIs
StatePublished - Apr 2006
Externally publishedYes

Keywords

  • DCD
  • Donation after cardiac death
  • Graft survival
  • Liver transplantation

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