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). CONCLUSION:We conclude that although DRI score predicts graft-liver survival, infectious complications depend more heavily on recipient factors.

journal_name

Surg Infect (Larchmt)

journal_title

Surgical infections

authors

Rosenberger LH,Gillen JR,Hranjec T,Stokes JB,Brayman KL,Kumer SC,Schmitt TM,Sawyer RG

doi

10.1089/sur.2013.035

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

94-8

issue

2

eissn

1096-2964

issn

1557-8674

journal_volume

15

pub_type

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