Outcome of liver transplantation based on donor graft quality and recipient status

B. Nemes, F. Gelley, G. Zádori, L. Piros, J. Perneczky, L. Kóbori, I. Fehérvári, D. Görög

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: Availability of suitable donor organs has always limited the number of liver transplantations performed. Use of marginal donor organs is an alternative to overcome organ shortage. Objective: To analyze the effect of various combinations of donor organ quality and recipient status on the outcome of liver transplantation. Materials and Methods: Data from 260 whole-liver transplantations performed between January 2003 and September 2009 were analyzed retrospectively. Study groups were established according to donor organ quality (marginal score 01 vs 25) and recipient status (Model for End-Stage Liver Disease [MELD] score 17). In patients at low risk, 102 received optimal grafts (good-to-good group [G/G], and 75 received marginal grafts (bad-to-good group [B/G]. In patients at high risk, 46 received optimal grafts (good-to-bad group [G/B], and 37 received marginal grafts (bad-to-bad group [B/B]. Results: No differences were observed in cumulative patient and graft survival rates; however, total survival differed in the early period after transplantation, that is, within 1 year. There was a higher rate of overall postoperative complications including initial poor graft function, bleeding, infection, and kidney failure in group B/B compared with group G/B (25 of 37 patients [67.5%] vs 27 of 46 patients [59.0%]), group B/G (25 of 37 patients [68%] vs 39 of 75 patients [52%], and group G/G (25 of 37 patients [68%] vs 43 of 102 patients [42%]) (P = .04). Patients with a high MELD score (G/B and B/B) demonstrated increased risk of postoperative complications. Use of donor organs with marginal score of 2 or higher in patients with high MELD scores increased early patient mortality. Conclusion: In summary, patients with a high MELD score (G/B and B/B) are at an increased risk of post-OLT complications. In contrast, use of marginal grafts (B/G and B/B) increased the rate of hepatitis C virus recurrence and decreased the response rate to antiviral therapy. The combination of impaired donor grafts and recipients at high risk should be avoided.

Original languageEnglish
Pages (from-to)2327-2330
Number of pages4
JournalTransplantation Proceedings
Volume42
Issue number6
DOIs
Publication statusPublished - Jul 2010

Fingerprint

Liver Transplantation
Tissue Donors
Transplants
End Stage Liver Disease
Graft Survival
Hepacivirus
Renal Insufficiency
Antiviral Agents
Survival Rate
Transplantation
Hemorrhage
Recurrence

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Outcome of liver transplantation based on donor graft quality and recipient status. / Nemes, B.; Gelley, F.; Zádori, G.; Piros, L.; Perneczky, J.; Kóbori, L.; Fehérvári, I.; Görög, D.

In: Transplantation Proceedings, Vol. 42, No. 6, 07.2010, p. 2327-2330.

Research output: Contribution to journalArticle

Nemes, B, Gelley, F, Zádori, G, Piros, L, Perneczky, J, Kóbori, L, Fehérvári, I & Görög, D 2010, 'Outcome of liver transplantation based on donor graft quality and recipient status', Transplantation Proceedings, vol. 42, no. 6, pp. 2327-2330. https://doi.org/10.1016/j.transproceed.2010.05.018
Nemes, B. ; Gelley, F. ; Zádori, G. ; Piros, L. ; Perneczky, J. ; Kóbori, L. ; Fehérvári, I. ; Görög, D. / Outcome of liver transplantation based on donor graft quality and recipient status. In: Transplantation Proceedings. 2010 ; Vol. 42, No. 6. pp. 2327-2330.
@article{17c22bd831ca4c819e7cd3d8d69db378,
title = "Outcome of liver transplantation based on donor graft quality and recipient status",
abstract = "Background: Availability of suitable donor organs has always limited the number of liver transplantations performed. Use of marginal donor organs is an alternative to overcome organ shortage. Objective: To analyze the effect of various combinations of donor organ quality and recipient status on the outcome of liver transplantation. Materials and Methods: Data from 260 whole-liver transplantations performed between January 2003 and September 2009 were analyzed retrospectively. Study groups were established according to donor organ quality (marginal score 01 vs 25) and recipient status (Model for End-Stage Liver Disease [MELD] score 17). In patients at low risk, 102 received optimal grafts (good-to-good group [G/G], and 75 received marginal grafts (bad-to-good group [B/G]. In patients at high risk, 46 received optimal grafts (good-to-bad group [G/B], and 37 received marginal grafts (bad-to-bad group [B/B]. Results: No differences were observed in cumulative patient and graft survival rates; however, total survival differed in the early period after transplantation, that is, within 1 year. There was a higher rate of overall postoperative complications including initial poor graft function, bleeding, infection, and kidney failure in group B/B compared with group G/B (25 of 37 patients [67.5{\%}] vs 27 of 46 patients [59.0{\%}]), group B/G (25 of 37 patients [68{\%}] vs 39 of 75 patients [52{\%}], and group G/G (25 of 37 patients [68{\%}] vs 43 of 102 patients [42{\%}]) (P = .04). Patients with a high MELD score (G/B and B/B) demonstrated increased risk of postoperative complications. Use of donor organs with marginal score of 2 or higher in patients with high MELD scores increased early patient mortality. Conclusion: In summary, patients with a high MELD score (G/B and B/B) are at an increased risk of post-OLT complications. In contrast, use of marginal grafts (B/G and B/B) increased the rate of hepatitis C virus recurrence and decreased the response rate to antiviral therapy. The combination of impaired donor grafts and recipients at high risk should be avoided.",
author = "B. Nemes and F. Gelley and G. Z{\'a}dori and L. Piros and J. Perneczky and L. K{\'o}bori and I. Feh{\'e}rv{\'a}ri and D. G{\"o}r{\"o}g",
year = "2010",
month = "7",
doi = "10.1016/j.transproceed.2010.05.018",
language = "English",
volume = "42",
pages = "2327--2330",
journal = "Transplantation Proceedings",
issn = "0041-1345",
publisher = "Elsevier USA",
number = "6",

}

TY - JOUR

T1 - Outcome of liver transplantation based on donor graft quality and recipient status

AU - Nemes, B.

AU - Gelley, F.

AU - Zádori, G.

AU - Piros, L.

AU - Perneczky, J.

AU - Kóbori, L.

AU - Fehérvári, I.

AU - Görög, D.

PY - 2010/7

Y1 - 2010/7

N2 - Background: Availability of suitable donor organs has always limited the number of liver transplantations performed. Use of marginal donor organs is an alternative to overcome organ shortage. Objective: To analyze the effect of various combinations of donor organ quality and recipient status on the outcome of liver transplantation. Materials and Methods: Data from 260 whole-liver transplantations performed between January 2003 and September 2009 were analyzed retrospectively. Study groups were established according to donor organ quality (marginal score 01 vs 25) and recipient status (Model for End-Stage Liver Disease [MELD] score 17). In patients at low risk, 102 received optimal grafts (good-to-good group [G/G], and 75 received marginal grafts (bad-to-good group [B/G]. In patients at high risk, 46 received optimal grafts (good-to-bad group [G/B], and 37 received marginal grafts (bad-to-bad group [B/B]. Results: No differences were observed in cumulative patient and graft survival rates; however, total survival differed in the early period after transplantation, that is, within 1 year. There was a higher rate of overall postoperative complications including initial poor graft function, bleeding, infection, and kidney failure in group B/B compared with group G/B (25 of 37 patients [67.5%] vs 27 of 46 patients [59.0%]), group B/G (25 of 37 patients [68%] vs 39 of 75 patients [52%], and group G/G (25 of 37 patients [68%] vs 43 of 102 patients [42%]) (P = .04). Patients with a high MELD score (G/B and B/B) demonstrated increased risk of postoperative complications. Use of donor organs with marginal score of 2 or higher in patients with high MELD scores increased early patient mortality. Conclusion: In summary, patients with a high MELD score (G/B and B/B) are at an increased risk of post-OLT complications. In contrast, use of marginal grafts (B/G and B/B) increased the rate of hepatitis C virus recurrence and decreased the response rate to antiviral therapy. The combination of impaired donor grafts and recipients at high risk should be avoided.

AB - Background: Availability of suitable donor organs has always limited the number of liver transplantations performed. Use of marginal donor organs is an alternative to overcome organ shortage. Objective: To analyze the effect of various combinations of donor organ quality and recipient status on the outcome of liver transplantation. Materials and Methods: Data from 260 whole-liver transplantations performed between January 2003 and September 2009 were analyzed retrospectively. Study groups were established according to donor organ quality (marginal score 01 vs 25) and recipient status (Model for End-Stage Liver Disease [MELD] score 17). In patients at low risk, 102 received optimal grafts (good-to-good group [G/G], and 75 received marginal grafts (bad-to-good group [B/G]. In patients at high risk, 46 received optimal grafts (good-to-bad group [G/B], and 37 received marginal grafts (bad-to-bad group [B/B]. Results: No differences were observed in cumulative patient and graft survival rates; however, total survival differed in the early period after transplantation, that is, within 1 year. There was a higher rate of overall postoperative complications including initial poor graft function, bleeding, infection, and kidney failure in group B/B compared with group G/B (25 of 37 patients [67.5%] vs 27 of 46 patients [59.0%]), group B/G (25 of 37 patients [68%] vs 39 of 75 patients [52%], and group G/G (25 of 37 patients [68%] vs 43 of 102 patients [42%]) (P = .04). Patients with a high MELD score (G/B and B/B) demonstrated increased risk of postoperative complications. Use of donor organs with marginal score of 2 or higher in patients with high MELD scores increased early patient mortality. Conclusion: In summary, patients with a high MELD score (G/B and B/B) are at an increased risk of post-OLT complications. In contrast, use of marginal grafts (B/G and B/B) increased the rate of hepatitis C virus recurrence and decreased the response rate to antiviral therapy. The combination of impaired donor grafts and recipients at high risk should be avoided.

UR - http://www.scopus.com/inward/record.url?scp=77955534215&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77955534215&partnerID=8YFLogxK

U2 - 10.1016/j.transproceed.2010.05.018

DO - 10.1016/j.transproceed.2010.05.018

M3 - Article

C2 - 20692473

AN - SCOPUS:77955534215

VL - 42

SP - 2327

EP - 2330

JO - Transplantation Proceedings

JF - Transplantation Proceedings

SN - 0041-1345

IS - 6

ER -