Organ availability is affecting the development of liver transplantation in its entirety, leading to transplant teams expanding the criteria for accepting organ donors.
In these circumstances, analysis of the impact of the donor's characteristics on graft survival becomes mandatory.
Dr Cuende and colleagues from Spain used univariate analysis to analyze 52 donor variables from 5150 liver transplants performed between 1994 to 2001.
The investigative team entered those with statistically significant impact on graft survival in a Cox regression model.
|Norepinephrine administration has a relative risk less than 1|
In the analysis, the team linked the recipients' characteristics and other factors to the graft technique.
The investigators found that several donor factors negatively affect graft survival, including donor age, cause of death, and body mass index.
The team also found that vasoactive drug administration, prolonged intensive care unit stay, and increased alkaline phosphatase negatively affected graft survival.
Additional factors that negatively affected graft survival included liver enzyme levels, low bicarbonate level, and antecedents of hypertension.
However, the research team identified only 4 risk factors graft loss when donor variables are controlled with recipient or technique variables in a Cox regression model.
The 4 risk factors that the team identified included donor age, antecedents of hypertension, prolonged intensive care unit stay, and low bicarbonate levels.
In the same analysis, the investigators observed that norepinephrine administration has a relative risk less than 1.
Dr Cuende's team concluded, “We conducted a multivariate analysis of the impact of 52 donor characteristics on liver graft survival.”
“This analysis showed the negative effect of an elderly donor, with hypertension combined with the presence of metabolic acidosis, or a prolonged intensive care unit donor stay.”
“The administration of norepinephrine alone during donor management showed a protective effect.”