Reuters Health Information (2005-03-23): Donor age, recipient status predict liver transplant survival
Donor age, recipient status predict liver transplant survival
Last Updated: 2005-03-23 15:11:33 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Three risk factors
associated with liver transplantation -- a donor age older than 60
years, prolonged transplant cold storage time, and poor patient status
prior to transplantation -- are associated with poor graft and patient
survival, researchers at Vanderbilt University Medical Center report.
Because the supply of donor livers is inadequate to meet the demand,
marginal donors are being used for liver transplantation, "and this has
consequences," lead author Dr. Derek E. Moore and his associates in
Nashville, Tennessee explain in their report, published in the March
Archives of Surgery.
To assess the influence of various factors on liver transplant
outcomes, Dr. Moore's group analyzed data from 483 adults who underwent
primary orthotopic liver transplantation between 1991 and 2003.
Five-year graft survival was 72% when donors were younger than 60
years versus 35% when donors were older. The figure was 71% for grafts
with less than 12 hours of cold ischemia time versus 58% for longer
cold storage. For United Network for Organ Sharing (UNOS) urgency
status 2B and 3, 5-year survival was 71% versus 60% for status 1 and 2A
The team's data suggest that when all three factors are optimal,
odds of patient survival for 5 years would be 75%, compared with 20% if
all three factors were suboptimal.
"Donor weight, warm ischemia time, sex mismatch, recipient age,
creatinine level, total bilirubin level, and cause of liver disease did
not significantly alter graft or patient survival," the researchers
Models based on pre-transplant characteristics "could be used to
make recipient-specific organ allocation decisions at the time of graft
procurement," they conclude.
Arch Surg 2005;140:273-277.