title: Impact of cumulative risk factors for expanded criteria donors on early survival after liver transplantation.
abstract: There are various options to help overcome the organ shortage, including performing transplants using grafts from marginal donors with characteristics previously described as unacceptable because of the high risk of graft failure. Nowadays, expanded criteria donors for liver transplantation (OLT) is a strategy used routinely by many teams. Some donor features have been suggested to jeopardize initial function or survival; when these features are aggregated, they may impact prognosis. The aim of this study was to evaluate the impact of donor risk factors on early patient survival and retransplantation. Donor risk factors were considered to be older than 60 years, body mass index > 30, serum sodium level > 155 mEq/L, cold ischemia time > 12 hours, and intensive care unit stay > 4 days. We prospectively recorded data from 139 patients who underwent 152 OLT from March 2003 to May 2007. Patients were classified into four groups: I, no risk factors; II, one risk factor; III, two risk factors; IV, three or more risk factors. Retransplantation or OLT due to acute liver failure was considered to be an exclusion criterion. Early overall survival rate was 83.76%; 12 retransplantations were required (10.25%). Comparing the four groups, patient survivals (P = .41) and retransplantation rates (P = .518) were similar. In conclusion, cumulative risk factors showed no impact on early (30-day) recipient survival and or on the necessity of retransplantation after OLT.
authors.affiliation: Liver Transplantation Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil.
authors.forename: R C
authors.initials: RC
authors.lastname: Afonso
authors.forename: R
authors.initials: R
authors.lastname: Hidalgo
authors.forename: A T
authors.initials: AT
authors.lastname: Paes
authors.forename: M P V C
authors.initials: MP
authors.lastname: Zurstrassen
authors.forename: L E P
authors.initials: LE
authors.lastname: Fonseca
authors.forename: F L
authors.initials: FL
authors.lastname: Pandullo
authors.forename: M B
authors.initials: MB
authors.lastname: Rezende
authors.forename: S P
authors.initials: SP
authors.lastname: Meira-Filho
authors.forename: B H
authors.initials: BH
authors.lastname: Ferraz-Neto
mesh_terms: D000328:Adult; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D016031:Liver Transplantation / Q000401:mortality*; D008875:Middle Aged; D018579:Patient Selection; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis