Who fares worse after liver transplantation? Impact of donor and recipient variables on outcome: data from a prospective study

Transplantation. 2013 Jun 27;95(12):1528-34. doi: 10.1097/TP.0b013e318292827f.

Abstract

Background: Numerous donor and recipient risk factors influence survival after liver transplantation (LT).

Methods: The aim of this study was to prospectively evaluate the effect of donor and recipient variables on 12-month patient and graft survival after LT. Five hundred forty-six patients underwent LT in a single center (2000-2010).

Results: Bilirubin (P=0.006) and cold ischemia time (P=0.002) were predictive of graft loss at 12 months after LT. Model for End-Stage Liver Disease score ≥25 was associated with a lower 12-month graft survival than Model for End-Stage Liver Disease score <15 (P=0.02). Hepatitis C virus (HCV)-positive patients showed a lower survival than HCV-negative patients 12 months after LT (P=0.04), with serum sodium concentration (P=0.01) predictive for graft survival. Donor age demonstrated a trend of prediction (P=0.05) for HCV-positive patient survival. In hepatocellular carcinoma patients, donor age (P=0.02 and 0.02) and use of partial graft (P=0.01 and 0.02) were predictive of patient and graft survival at 12 months after LT.

Conclusions: Bilirubin and cold ischemia time are crucial for graft outcome post-LT. Survival in HCV-positive patients is lower than in HCV-negative recipients. Donor age and partial graft use are predictive of patient and graft survival in hepatocellular carcinoma patients.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Bilirubin / metabolism
  • Carcinoma, Hepatocellular / pathology
  • End Stage Liver Disease / pathology
  • Female
  • Graft Survival*
  • Hepacivirus
  • Hepatitis C / complications
  • Humans
  • Ischemia
  • Liver Transplantation / methods*
  • Living Donors*
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Bilirubin