title: Donor risk index predicts graft failure reliably but not post-transplant infections.
abstract: BACKGROUND
  The Donor Risk Index (DRI) is used to predict graft survival following liver transplantation, but has not been used to predict post-operative infections in graft recipients. We hypothesized that lower-quality grafts would result in more frequent infectious complications.
  
  
  METHODS
  Using a prospectively collected infection data set, we matched liver transplant recipients (and the respective allograft DRI scores) with their specific post-transplant infectious complications. All transplant recipients were organized by DRI score and divided into groups with low-DRI and high-DRI scores.
  
  
  RESULTS
  We identified 378 liver transplants, with 189 recipients each in the low-DRI and high-DRI groups. The mean DRI scores for the low- and high-DRI-score groups were 1.14±0.01 and 1.74±0.02, respectively (p<0.0001 for the difference). The mean Model for End-Stage Liver Disease (MELD) scores were 26.25±0.53 and 24.76±0.55, respectively (p=0.052), and the mean number of infectious complications per patient were 1.60±0.19 and 1.94±0.24, respectively (p=0.26). Logistic regression showed only length of hospital stay and a history of vascular disease as being associated independently with infection, with a trend toward significance for MELD score (p=0.13).
  
  
  CONCLUSIONS
  We conclude that although DRI score predicts graft-liver survival, infectious complications depend more heavily on recipient factors.
authors.affiliation: 1 Department of Surgery, University of Virginia Health System , Charlottesville, Virginia.
authors.forename: Laura H
authors.initials: LH
authors.lastname: Rosenberger
authors.forename: Jacob R
authors.initials: JR
authors.lastname: Gillen
authors.forename: Tjasa
authors.initials: T
authors.lastname: Hranjec
authors.forename: Jayme B
authors.initials: JB
authors.lastname: Stokes
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Brayman
authors.forename: Sean C
authors.initials: SC
authors.lastname: Kumer
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Schmitt
authors.forename: Robert G
authors.initials: RG
authors.lastname: Sawyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D055815:Young Adult