Davila et al listed two equations for predicting the probability of donor arrest and graft refusal iin potential liver donors.
Patient selection: donor in the intensive therapy unit (ITU)
Parameters:
(1) donor age in years
(2) donor gag and cough reflex
(3) use of inotropes in donor
(4) donor’s body mass index (BMI)
(5) number of days donor in ITU
(6) ratio of donor serum ALT to upper limit of normal (ULN)
(7) warm ischemia time (WIT) in minutes
ratio of serum ALT to ULN =
= (donor serum ALT) / (ULN for serum ALT)
|
Parameter |
Findings |
Points |
|
age for donor arrest |
< 40 years |
0 |
|
|
>= 40 |
1 |
|
age for graft refusal |
< 50 years |
0 |
|
|
>= 50 years |
|
|
inotropes used |
no |
0 |
|
|
yes |
1 |
|
gag and cough reflex present |
no |
1 |
|
|
yes |
0 |
|
body mass index |
< 30 kg per square meter |
0 |
|
|
>= 30 kg per square meter |
1 |
|
number of days in ITU |
< 7 days |
0 |
|
|
>= 7 days |
1 |
|
ratio of ALT to ULN |
< 4 |
0 |
|
|
>= 4 |
1 |
|
warm ischemia time |
< 25 minutes |
0 |
|
|
>= 25 minutes |
25 |
where:
• Gag and cough reflex scoring can be done in 2 ways (both absent or present, one absent or present). In the implementation the absence of both is scored as 1 else 0.
X for donor arrest =
= (1.6 * (points for inotropes)) – (1.27 * (points for age)) – (1.92 * (points for gag or cough reflex)) + 2.4
probability of donor arrest =
= 1 / (1 + EXP((-1) * X))
Y for graft refusal =
= (1.03 * (points for age)) + (1.8 * (points for BMI)) + (1.26 * (points for days in ITU)) + (1.159 * (points for ALT ratio)) + (1.72 * (warm ischemia time)) – 5.8
probability of graft refusal =
= 1 / (1 + EXP((-1) * Y))
Specialty: Critical Care, Emergency Medicine
ICD-10: ,
