Critical use of extended criteria donor liver grafts in adult-to-adult whole liver transplantation

A single-center experience

Salvatore Gruttadauria, Giovanni Vizzini, Domenico Biondo, Lucio Mandalà, Riccardo Volpes, Ugo Palazzo, Bruno Gridelli

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

This study presents our experience with the use of extended criteria donor (ECD) liver grafts. One hundred fifteen liver transplants were divided into 2 groups: standard (S) and nonstandard (NS). Fifty-eight patients in group S received a liver procured from an ideal donor, whereas 57 patients in group NS received an organ from an ECD. On the basis of the number of risk factors, patients were divided into 3 subgroups: the S group with 58 receiving a standard graft, the NS1 group with 44 receiving a graft with 1 or 2 risk factors, and the NS2 group with 13 receiving a graft with 3 to 4 risk factors. Patient survival was not different at 6, 12, and 24 months (P > 0.05), whereas graft survival was different (P = 0.0079). Both patient survival and graft survival were influenced by the cumulative number of risk factors. The univariate analysis of the donor risk factors detected hemodynamic factors as predictive of graft failure (P = 0.024) and death (P = 0.018). In the multivariate analysis, which was adjusted for recipient age and donor and recipient gender, hemodynamic risk factors and Model for End-Stage Liver. Disease score in the recipient were the only variables independently associated with graft failure (P = 0.006, P = 0.012, negatively). Finally, we observed a reduction of dropout from the list to 9% from 14.1% (P = 0.04) and of mortality on the list to 32.55% from 41.01% (P = 0.11). Critical use of ECD liver grafts allowed recipients in the waiting list to have a greater chance of being transplanted.

Original languageEnglish
Pages (from-to)220-227
Number of pages8
JournalLiver Transplantation
Volume14
Issue number2
DOIs
Publication statusPublished - Feb 2008

Fingerprint

Liver Transplantation
Tissue Donors
Transplants
Liver
Graft Survival
Hemodynamics
Waiting Lists
Survival
Multivariate Analysis
Mortality

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Critical use of extended criteria donor liver grafts in adult-to-adult whole liver transplantation : A single-center experience. / Gruttadauria, Salvatore; Vizzini, Giovanni; Biondo, Domenico; Mandalà, Lucio; Volpes, Riccardo; Palazzo, Ugo; Gridelli, Bruno.

In: Liver Transplantation, Vol. 14, No. 2, 02.2008, p. 220-227.

Research output: Contribution to journalArticle

Gruttadauria, Salvatore ; Vizzini, Giovanni ; Biondo, Domenico ; Mandalà, Lucio ; Volpes, Riccardo ; Palazzo, Ugo ; Gridelli, Bruno. / Critical use of extended criteria donor liver grafts in adult-to-adult whole liver transplantation : A single-center experience. In: Liver Transplantation. 2008 ; Vol. 14, No. 2. pp. 220-227.
@article{36bb52e8109248099118dbb683f72b11,
title = "Critical use of extended criteria donor liver grafts in adult-to-adult whole liver transplantation: A single-center experience",
abstract = "This study presents our experience with the use of extended criteria donor (ECD) liver grafts. One hundred fifteen liver transplants were divided into 2 groups: standard (S) and nonstandard (NS). Fifty-eight patients in group S received a liver procured from an ideal donor, whereas 57 patients in group NS received an organ from an ECD. On the basis of the number of risk factors, patients were divided into 3 subgroups: the S group with 58 receiving a standard graft, the NS1 group with 44 receiving a graft with 1 or 2 risk factors, and the NS2 group with 13 receiving a graft with 3 to 4 risk factors. Patient survival was not different at 6, 12, and 24 months (P > 0.05), whereas graft survival was different (P = 0.0079). Both patient survival and graft survival were influenced by the cumulative number of risk factors. The univariate analysis of the donor risk factors detected hemodynamic factors as predictive of graft failure (P = 0.024) and death (P = 0.018). In the multivariate analysis, which was adjusted for recipient age and donor and recipient gender, hemodynamic risk factors and Model for End-Stage Liver. Disease score in the recipient were the only variables independently associated with graft failure (P = 0.006, P = 0.012, negatively). Finally, we observed a reduction of dropout from the list to 9{\%} from 14.1{\%} (P = 0.04) and of mortality on the list to 32.55{\%} from 41.01{\%} (P = 0.11). Critical use of ECD liver grafts allowed recipients in the waiting list to have a greater chance of being transplanted.",
author = "Salvatore Gruttadauria and Giovanni Vizzini and Domenico Biondo and Lucio Mandal{\`a} and Riccardo Volpes and Ugo Palazzo and Bruno Gridelli",
year = "2008",
month = "2",
doi = "10.1002/lt.21359",
language = "English",
volume = "14",
pages = "220--227",
journal = "Liver Transplantation",
issn = "1527-6465",
publisher = "John Wiley and Sons Ltd",
number = "2",

}

TY - JOUR

T1 - Critical use of extended criteria donor liver grafts in adult-to-adult whole liver transplantation

T2 - A single-center experience

AU - Gruttadauria, Salvatore

AU - Vizzini, Giovanni

AU - Biondo, Domenico

AU - Mandalà, Lucio

AU - Volpes, Riccardo

AU - Palazzo, Ugo

AU - Gridelli, Bruno

PY - 2008/2

Y1 - 2008/2

N2 - This study presents our experience with the use of extended criteria donor (ECD) liver grafts. One hundred fifteen liver transplants were divided into 2 groups: standard (S) and nonstandard (NS). Fifty-eight patients in group S received a liver procured from an ideal donor, whereas 57 patients in group NS received an organ from an ECD. On the basis of the number of risk factors, patients were divided into 3 subgroups: the S group with 58 receiving a standard graft, the NS1 group with 44 receiving a graft with 1 or 2 risk factors, and the NS2 group with 13 receiving a graft with 3 to 4 risk factors. Patient survival was not different at 6, 12, and 24 months (P > 0.05), whereas graft survival was different (P = 0.0079). Both patient survival and graft survival were influenced by the cumulative number of risk factors. The univariate analysis of the donor risk factors detected hemodynamic factors as predictive of graft failure (P = 0.024) and death (P = 0.018). In the multivariate analysis, which was adjusted for recipient age and donor and recipient gender, hemodynamic risk factors and Model for End-Stage Liver. Disease score in the recipient were the only variables independently associated with graft failure (P = 0.006, P = 0.012, negatively). Finally, we observed a reduction of dropout from the list to 9% from 14.1% (P = 0.04) and of mortality on the list to 32.55% from 41.01% (P = 0.11). Critical use of ECD liver grafts allowed recipients in the waiting list to have a greater chance of being transplanted.

AB - This study presents our experience with the use of extended criteria donor (ECD) liver grafts. One hundred fifteen liver transplants were divided into 2 groups: standard (S) and nonstandard (NS). Fifty-eight patients in group S received a liver procured from an ideal donor, whereas 57 patients in group NS received an organ from an ECD. On the basis of the number of risk factors, patients were divided into 3 subgroups: the S group with 58 receiving a standard graft, the NS1 group with 44 receiving a graft with 1 or 2 risk factors, and the NS2 group with 13 receiving a graft with 3 to 4 risk factors. Patient survival was not different at 6, 12, and 24 months (P > 0.05), whereas graft survival was different (P = 0.0079). Both patient survival and graft survival were influenced by the cumulative number of risk factors. The univariate analysis of the donor risk factors detected hemodynamic factors as predictive of graft failure (P = 0.024) and death (P = 0.018). In the multivariate analysis, which was adjusted for recipient age and donor and recipient gender, hemodynamic risk factors and Model for End-Stage Liver. Disease score in the recipient were the only variables independently associated with graft failure (P = 0.006, P = 0.012, negatively). Finally, we observed a reduction of dropout from the list to 9% from 14.1% (P = 0.04) and of mortality on the list to 32.55% from 41.01% (P = 0.11). Critical use of ECD liver grafts allowed recipients in the waiting list to have a greater chance of being transplanted.

UR - http://www.scopus.com/inward/record.url?scp=39449138744&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=39449138744&partnerID=8YFLogxK

U2 - 10.1002/lt.21359

DO - 10.1002/lt.21359

M3 - Article

VL - 14

SP - 220

EP - 227

JO - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 2

ER -