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The difficulty in defining extended donor criteria for liver grafts: the Eurotransplant experience

(2013) TRANSPLANT INTERNATIONAL. 26(10). p.990-998
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Abstract
Donor criteria for liver grafts have been expanded because of organ shortage. Currently, no exact definitions for extended donor grafts have been established. The aim of this study was to analyze the impact of donor-specific risk factors, independent of recipient characteristics. In collaboration with Eurotransplant and European Liver Transplant Register, solely donor-specific parameters were correlated with 1-year survival following liver transplantation. Analyses of 4701 donors between 2000 and 2005 resulted in the development of a nomogram to estimate graft survival for available grafts. Predictions by nomogram were compared to those by Donor Risk Index (DRI). In the multivariate analysis, cold ischemic time (CIT), highest sodium, cause of donor death, -glutamyl transferase (-GT), and donor sex (female) were statistically significant factors for 3months; CIT, -GT, and cause of donor death for 12-month survival. The median DRI of this study population was 1.45 (Q1: 1.17; Q3: 1.67). The agreement between the nomogram and DRI was weak (kappa=0.23). Several donor-specific risk factors were identified for early survival after liver transplantation. The provided nomogram will support quick organ quality assessment. Nevertheless, this study showed the difficulties of determining an exact definition of extended criteria donors.
Keywords
extended liver donor criteria, donor evaluation, liver transplantation, organ quality, GAMMA-GLUTAMYL-TRANSFERASE, SINGLE-CENTER EXPERIENCE, RISK INDEX, EXPANDED CRITERIA, TRANSPLANTATION, SURVIVAL, GENDER, RECIPIENT, MORTALITY, ADULTS

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Chicago
Silberhumer, Gerd R, Axel Rahmel, Vincent Karam, Mithat Gonen, Georg Gyoeri, Barbara Kern, Rene Adam, et al. 2013. “The Difficulty in Defining Extended Donor Criteria for Liver Grafts: The Eurotransplant Experience.” Transplant International 26 (10): 990–998.
APA
Silberhumer, G. R., Rahmel, A., Karam, V., Gonen, M., Gyoeri, G., Kern, B., Adam, R., et al. (2013). The difficulty in defining extended donor criteria for liver grafts: the Eurotransplant experience. TRANSPLANT INTERNATIONAL, 26(10), 990–998.
Vancouver
1.
Silberhumer GR, Rahmel A, Karam V, Gonen M, Gyoeri G, Kern B, et al. The difficulty in defining extended donor criteria for liver grafts: the Eurotransplant experience. TRANSPLANT INTERNATIONAL. 2013;26(10):990–8.
MLA
Silberhumer, Gerd R, Axel Rahmel, Vincent Karam, et al. “The Difficulty in Defining Extended Donor Criteria for Liver Grafts: The Eurotransplant Experience.” TRANSPLANT INTERNATIONAL 26.10 (2013): 990–998. Print.
@article{5723236,
  abstract     = {Donor criteria for liver grafts have been expanded because of organ shortage. Currently, no exact definitions for extended donor grafts have been established. The aim of this study was to analyze the impact of donor-specific risk factors, independent of recipient characteristics. In collaboration with Eurotransplant and European Liver Transplant Register, solely donor-specific parameters were correlated with 1-year survival following liver transplantation. Analyses of 4701 donors between 2000 and 2005 resulted in the development of a nomogram to estimate graft survival for available grafts. Predictions by nomogram were compared to those by Donor Risk Index (DRI). In the multivariate analysis, cold ischemic time (CIT), highest sodium, cause of donor death, -glutamyl transferase (-GT), and donor sex (female) were statistically significant factors for 3months; CIT, -GT, and cause of donor death for 12-month survival. The median DRI of this study population was 1.45 (Q1: 1.17; Q3: 1.67). The agreement between the nomogram and DRI was weak (kappa=0.23). Several donor-specific risk factors were identified for early survival after liver transplantation. The provided nomogram will support quick organ quality assessment. Nevertheless, this study showed the difficulties of determining an exact definition of extended criteria donors.},
  author       = {Silberhumer, Gerd R and Rahmel, Axel and Karam, Vincent and Gonen, Mithat and Gyoeri, Georg and Kern, Barbara and Adam, Rene and Muehlbacher, Ferdinand and Rogiers, Xavier and Burroughs, Andrew K and Berlakovich, Gabriela A},
  issn         = {0934-0874},
  journal      = {TRANSPLANT INTERNATIONAL},
  keywords     = {extended liver donor criteria,donor evaluation,liver transplantation,organ quality,GAMMA-GLUTAMYL-TRANSFERASE,SINGLE-CENTER EXPERIENCE,RISK INDEX,EXPANDED CRITERIA,TRANSPLANTATION,SURVIVAL,GENDER,RECIPIENT,MORTALITY,ADULTS},
  language     = {eng},
  number       = {10},
  pages        = {990--998},
  title        = {The difficulty in defining extended donor criteria for liver grafts: the Eurotransplant experience},
  url          = {http://dx.doi.org/10.1111/tri.12156},
  volume       = {26},
  year         = {2013},
}

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