title: Donor diabetes mellitus is an independent risk factor for graft loss in HCV positive but not HCV negative liver transplant recipients.
abstract: OBJECTIVE
  Graft survival in HCV (hepatitis C virus) infected recipients is worse than those transplanted for other liver diseases. We studied whether several donor cardiovascular risk factors (including advanced age, smoking, hypertension, and diabetes mellitus) contribute to worse outcomes for HCV positive and HCV negative liver transplant recipients.
  
  
  METHODS
  We obtained data from the United Network for Organ Sharing on all adult liver transplants performed in the United States between January 1, 1998 and December 31, 2003. In total, 27,033 transplant cases were evaluated. Independent predictors of graft survival were determined using Cox proportional hazards regression analysis after controlling for factors previously found to be associated with differences in transplant outcomes.
  
  
  RESULTS
  Donor diabetes was a strong independent risk factor for graft failure [hazard ratio (HR) = 1.20, p = 0.006] only in HCV positive recipients. Neither donor smoking status nor hypertension predicted graft loss in either cohort. Consistent with previous studies, advanced donor age, donation after cardiac death, height, and African American donor all predicted graft loss amongst both cohorts.
  
  
  CONCLUSIONS
  Accounting for donor diabetes in relation to recipient HCV status in the selection of liver recipients may result in improved graft survival.
authors.affiliation: Division of Gastroenterology, Massachusetts General Hospital, 55 Fruit St, Blake 4, Boston, MA 02114, USA. yingny@gmail.com
authors.forename: Ying
authors.initials: Y
authors.lastname: Wu
authors.forename: Aijaz
authors.initials: A
authors.lastname: Ahmed
authors.forename: Ahmad
authors.initials: A
authors.lastname: Kamal
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality*; D005260:Female; D006085:Graft Survival; D019698:Hepatitis C, Chronic / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055031:Primary Graft Dysfunction / Q000401:mortality*; D016016:Proportional Hazards Models; D012307:Risk Factors; D014019:Tissue Donors / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology