Impact of the donor risk index on the outcome of hepatitis C virus-positive Liver transplant recipients

Daniel Maluf, Erick B. Edwards, R. Todd Stravitz, H. Myron Kauftman

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

We have investigated the impact of the donor risk index (DRI) on the outcome of hepatitis C virus (HCV)-infected patients undergoing liver transplantation (LTx). Retrospective analysis was performed from the Organ Procurement and Transplantation Network database (January 1, 2000 to June, 2006). The DRI was calculated as described by Feng et al. (Am J Transplant 2006;6:783-790). Model for End-Stage Liver Disease (MELD) exceptions were excluded from the analysis. Relative risk (RR) estimates of patient and graft loss were derived from Cox regression models. The Wald test was used to test the effect of the MELD score at transplant on the HCV-DRI interaction. Of the LTx recipients (16,678), 76.1% were Caucasian, and 66.7% were male; the median age was 52 (range, 18-80 years), and the mean follow-up time was 1148 days (range, 0-2959 days). Forty-six percent (n = 7675) of LTx recipients were HCV(+). The median DRI was 1.3 (range, 0.77-4.27). Increasing DRI was associated with a statistically significant increase in the RR of graft failure and patient death for both HCV(+) and HCV(-) recipients. However, HCV(+) recipients demonstrated a significantly higher increase in the RR of patient and graft loss as a function of the DRI than HCV(-) subjects, even after adjustments for several recipient factors, including MELD. In conclusion, a synergistic interaction between donor DRI and recipient HCV status exists, such that an allograft from a high-DRI donor more adversely affects the outcome of an HCV(+) recipient than that of an HCV(-) recipient.

Original languageEnglish (US)
Pages (from-to)592-599
Number of pages8
JournalLiver Transplantation
Volume15
Issue number6
DOIs
StatePublished - Aug 14 2009
Externally publishedYes

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Hepacivirus
Tissue Donors
Liver
End Stage Liver Disease
Transplants
Transplant Recipients
Tissue and Organ Procurement
Organ Transplantation
Proportional Hazards Models
Liver Transplantation
Allografts
Databases

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology
  • Transplantation

Cite this

Impact of the donor risk index on the outcome of hepatitis C virus-positive Liver transplant recipients. / Maluf, Daniel; Edwards, Erick B.; Stravitz, R. Todd; Kauftman, H. Myron.

In: Liver Transplantation, Vol. 15, No. 6, 14.08.2009, p. 592-599.

Research output: Contribution to journalArticle

Maluf, Daniel ; Edwards, Erick B. ; Stravitz, R. Todd ; Kauftman, H. Myron. / Impact of the donor risk index on the outcome of hepatitis C virus-positive Liver transplant recipients. In: Liver Transplantation. 2009 ; Vol. 15, No. 6. pp. 592-599.
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