| Autor: |
Schoening, Wenzel, Helbig, Michael, Buescher, Niklas, Andreou, Andreas, Schmitz, Volker, Bahra, Marcus, Puhl, Gero, Pascher, Andreas, Pratschke, Johann, Seehofer, Daniel |
| Předmět: |
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| Zdroj: |
Clinical Transplantation; May2016, Vol. 30 Issue 5, p508-517, 10p |
| Abstrakt: |
The organ shortage has led to increased use of marginal organs. The Eurotransplant Donor-Risk-Index ( ET- DRI) was established to estimate outcome after Liver Transplantation ( LT). Currently, data on impact of ET- DRI on long-term outcome for different indications and recipient conditions are missing. Retrospective, single-center analysis of long-term graft survival ( GS) of 1767 adult primary LTs according to indication, lab MELD category ( 1: ≤18; 2: >18-25; 3: >25-35; 4: >35), and ET- DRI. Mean ET- DRI in our cohort was 1.63 (±0.43). One-, 10, and 15-yr GS was 83.5%, 63.3%, and 54.8%. Long-term GS was significantly influenced by ET- DRI. Accordingly, four ET- DRI categories were defined and analyzed with respect to underlying disease. Significant impact of these categories was observed for: Alcohol, cholestatic/autoimmune diseases ( CD/ AIH), and HCV, but not for HCC, HBV, cryptogenic cirrhosis, and acute liver failure. lab MELD categories showed no significant influence on graft, but on patient survival. Matching ET- DRI categories with lab MELD revealed significant differences in long-term GS for lab MELD categories 1, 2, and 3, but not 4. In multivariate analysis, HCV combined with ET- DRI > 2 and lab MELD category 3 combined with ET- DRI > 2 emerged as negative predictors. To achieve excellent long-term graft survival, higher risk organs ( ET- DRI > 1.4) should be used restrictively for patients with CD/ AIH or HCV. Organs with ET-DRI > 2 should be avoided in patients with a lab MELD of >25-35. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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