title: Analysis of donor risk factors associated with graft outcomes in orthotopic liver transplantation.
abstract: BACKGROUND
  In orthotopic liver transplantation (OLT), the critical shortage of organ donors is the reason for accepting marginal donors. Although the outcome of OLT does not entirely seem to have been affected by the use of such donors identification of predictive risk factors is challenging. This study sought to identify significant risk factors associated with graft outcomes in our institute.
  
  
  METHODS
  We retrospectively analyzed donor-associated factors for recipients who underwent liver transplantation from January 2002 to December 2009 for displaying primary dysfunction (PDF) as primary nonfunction (PNF) and initial poor function (IPF).
  
  
  RESULTS
  We examined 97 post-liver transplant patients (male:female 70:27) whose average age was 52.74 years. The majority of indications for OLT were hepatitis B and/or C cirrhosis, alcoholic cirrhosis, and hepatocellular carcinoma. The incidence of PDF was 31.9% (31/97) including 7.2% PNF (7/97) and 24.7% IPF (24/97), versus 68.1% (66/97) with immediate function. The donors last serum alanine aminotransferase value being more than 65 IU/L was the only risk factor for poor graft function (P=.034). Donor peak and last serum sodium were potential risk factors.
  
  
  CONCLUSIONS
  Although many factors including a high serum sodium level are associated with a marginal liver graft, Last donor alanine aminotransferase level was the only significant factor that predicted the PDF.
authors.affiliation: Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Y
authors.initials: Y
authors.lastname: Sirivatanauksorn
authors.forename: V
authors.initials: V
authors.lastname: Taweerutchana
authors.forename: S
authors.initials: S
authors.lastname: Limsrichamrern
authors.forename: P
authors.initials: P
authors.lastname: Kositamongkol
authors.forename: P
authors.initials: P
authors.lastname: Mahawithitwong
authors.forename: S
authors.initials: S
authors.lastname: Asavakarn
authors.forename: C
authors.initials: C
authors.lastname: Tovikkai
authors.forename: V
authors.initials: V
authors.lastname: Sanphasitvong
mesh_terms: D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D046148:Donor Selection; D005260:Female; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors / Q000600:supply & distribution*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D055031:Primary Graft Dysfunction / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012964:Sodium / Q000097:blood; D013785:Thailand; D016896:Treatment Outcome; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D015415:Biomarkers; D012964:Sodium; D000410:Alanine Transaminase