Characteristics associated with liver graft failure

The concept of a donor risk index

S. Feng, N. P. Goodrich, J. L. Bragg-Gresham, D. M. Dykstra, J. D. Punch, M. A. DebRoy, Stuart M. Greenstein, R. M. Merion

Research output: Contribution to journalArticle

1078 Citations (Scopus)

Abstract

Transplant physicians and candidates have become increasingly aware that donor characteristics significantly impact liver transplantation outcomes. Although the qualitative effect of individual donor variables are understood, the quantitative risk associated with combinations of characteristics are unclear. Using national data from 1998 to 2002, we developed a quantitative donor risk index. Cox regression models identified seven donor characteristics that independently predicted significantly increased risk of graft failure. Donor age over 40 years (and particularly over 60 years), donation after cardiac death (DCD), and split/partial grafts were strongly associated with graft failure, while African-American race, less height, cerebrovascular accident and 'other' causes of brain death were more modestly but still significantly associated with graft failure. Grafts with an increased donor risk index have been preferentially transplanted into older candidates (>50 years of age) with moderate disease severity (nonstatus 1 with lower model for end-stage liver disease (MELD) scores) and without hepatitis C. Quantitative assessment of the risk of donor liver graft failure using a donor risk index is useful to inform the process of organ acceptance.

Original languageEnglish (US)
Pages (from-to)783-790
Number of pages8
JournalAmerican Journal of Transplantation
Volume6
Issue number4
DOIs
StatePublished - Apr 2006

Fingerprint

Liver Failure
Tissue Donors
Transplants
End Stage Liver Disease
Brain Death
Hepatitis C
Proportional Hazards Models
African Americans
Liver Transplantation
Cause of Death
Stroke
Physicians

ASJC Scopus subject areas

  • Immunology

Cite this

Feng, S., Goodrich, N. P., Bragg-Gresham, J. L., Dykstra, D. M., Punch, J. D., DebRoy, M. A., ... Merion, R. M. (2006). Characteristics associated with liver graft failure: The concept of a donor risk index. American Journal of Transplantation, 6(4), 783-790. https://doi.org/10.1111/j.1600-6143.2006.01242.x

Characteristics associated with liver graft failure : The concept of a donor risk index. / Feng, S.; Goodrich, N. P.; Bragg-Gresham, J. L.; Dykstra, D. M.; Punch, J. D.; DebRoy, M. A.; Greenstein, Stuart M.; Merion, R. M.

In: American Journal of Transplantation, Vol. 6, No. 4, 04.2006, p. 783-790.

Research output: Contribution to journalArticle

Feng, S, Goodrich, NP, Bragg-Gresham, JL, Dykstra, DM, Punch, JD, DebRoy, MA, Greenstein, SM & Merion, RM 2006, 'Characteristics associated with liver graft failure: The concept of a donor risk index', American Journal of Transplantation, vol. 6, no. 4, pp. 783-790. https://doi.org/10.1111/j.1600-6143.2006.01242.x
Feng, S. ; Goodrich, N. P. ; Bragg-Gresham, J. L. ; Dykstra, D. M. ; Punch, J. D. ; DebRoy, M. A. ; Greenstein, Stuart M. ; Merion, R. M. / Characteristics associated with liver graft failure : The concept of a donor risk index. In: American Journal of Transplantation. 2006 ; Vol. 6, No. 4. pp. 783-790.
@article{7f482b0df4144639be36e9ed3e7683a9,
title = "Characteristics associated with liver graft failure: The concept of a donor risk index",
abstract = "Transplant physicians and candidates have become increasingly aware that donor characteristics significantly impact liver transplantation outcomes. Although the qualitative effect of individual donor variables are understood, the quantitative risk associated with combinations of characteristics are unclear. Using national data from 1998 to 2002, we developed a quantitative donor risk index. Cox regression models identified seven donor characteristics that independently predicted significantly increased risk of graft failure. Donor age over 40 years (and particularly over 60 years), donation after cardiac death (DCD), and split/partial grafts were strongly associated with graft failure, while African-American race, less height, cerebrovascular accident and 'other' causes of brain death were more modestly but still significantly associated with graft failure. Grafts with an increased donor risk index have been preferentially transplanted into older candidates (>50 years of age) with moderate disease severity (nonstatus 1 with lower model for end-stage liver disease (MELD) scores) and without hepatitis C. Quantitative assessment of the risk of donor liver graft failure using a donor risk index is useful to inform the process of organ acceptance.",
author = "S. Feng and Goodrich, {N. P.} and Bragg-Gresham, {J. L.} and Dykstra, {D. M.} and Punch, {J. D.} and DebRoy, {M. A.} and Greenstein, {Stuart M.} and Merion, {R. M.}",
year = "2006",
month = "4",
doi = "10.1111/j.1600-6143.2006.01242.x",
language = "English (US)",
volume = "6",
pages = "783--790",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Characteristics associated with liver graft failure

T2 - The concept of a donor risk index

AU - Feng, S.

AU - Goodrich, N. P.

AU - Bragg-Gresham, J. L.

AU - Dykstra, D. M.

AU - Punch, J. D.

AU - DebRoy, M. A.

AU - Greenstein, Stuart M.

AU - Merion, R. M.

PY - 2006/4

Y1 - 2006/4

N2 - Transplant physicians and candidates have become increasingly aware that donor characteristics significantly impact liver transplantation outcomes. Although the qualitative effect of individual donor variables are understood, the quantitative risk associated with combinations of characteristics are unclear. Using national data from 1998 to 2002, we developed a quantitative donor risk index. Cox regression models identified seven donor characteristics that independently predicted significantly increased risk of graft failure. Donor age over 40 years (and particularly over 60 years), donation after cardiac death (DCD), and split/partial grafts were strongly associated with graft failure, while African-American race, less height, cerebrovascular accident and 'other' causes of brain death were more modestly but still significantly associated with graft failure. Grafts with an increased donor risk index have been preferentially transplanted into older candidates (>50 years of age) with moderate disease severity (nonstatus 1 with lower model for end-stage liver disease (MELD) scores) and without hepatitis C. Quantitative assessment of the risk of donor liver graft failure using a donor risk index is useful to inform the process of organ acceptance.

AB - Transplant physicians and candidates have become increasingly aware that donor characteristics significantly impact liver transplantation outcomes. Although the qualitative effect of individual donor variables are understood, the quantitative risk associated with combinations of characteristics are unclear. Using national data from 1998 to 2002, we developed a quantitative donor risk index. Cox regression models identified seven donor characteristics that independently predicted significantly increased risk of graft failure. Donor age over 40 years (and particularly over 60 years), donation after cardiac death (DCD), and split/partial grafts were strongly associated with graft failure, while African-American race, less height, cerebrovascular accident and 'other' causes of brain death were more modestly but still significantly associated with graft failure. Grafts with an increased donor risk index have been preferentially transplanted into older candidates (>50 years of age) with moderate disease severity (nonstatus 1 with lower model for end-stage liver disease (MELD) scores) and without hepatitis C. Quantitative assessment of the risk of donor liver graft failure using a donor risk index is useful to inform the process of organ acceptance.

UR - http://www.scopus.com/inward/record.url?scp=33644747688&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33644747688&partnerID=8YFLogxK

U2 - 10.1111/j.1600-6143.2006.01242.x

DO - 10.1111/j.1600-6143.2006.01242.x

M3 - Article

VL - 6

SP - 783

EP - 790

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

IS - 4

ER -