Description

Feng et al developed a donor risk index (DRI) to evaluate the liver donor for factors that impact liver graft failure in the recipient. The authors are from the University of San Francisco, University of Michigan, University of Medicine and Dentistry of New Jersey and Albert Einstein College of Medicine.


 

Patient selection: liver donor

 

Parameters:

(1) donor age in years

(2) cause of death (COD)

(3) race

(4) donation after cardiac death (DCD)

(5) status of donor liver

(6) height in centimeters

(7) transplant network type

(8) cold time in hours

Parameter

Finding

Points

donor age

< 40 years

0

 

40 to 49.99

0.154

 

50 to 59.99

0.274

 

60 to 69.99

0.424

 

>= 70

0.50

cause of death

anoxia

0.079

 

stroke (CVA)

0.145

 

trauma

0

 

other (not trauma, stroke or anoxia)

0.184

race

African American

0.176

 

White

0

 

other

0.126

donation after cardiac death

no

0

 

yes

0.411

status of donor liver

intact

0

 

partial or split

0.422

transplant network

regional share

0.105

 

national share

0.244

 

local

0

 

where:

• The other category for race and cause of death is ambiguous. The categories in Table 2 are used.

 

points for height =

= 0.066 * (170 – (height in cm)) / 10 =

= 0.0066 * (170 – (height in cm))

 

points for cold time =

= (0.010 * (cold time in hours)

 

X =

= SUM(points for all of the parameters)

 

donor risk index =

= EXP(X)

 

Interpretation:

• minimum DRI: near 0

• The higher the DRI the worse the graft survival.

• In 1998-2002 the 3 year graft survival was 81% for a DRI <= 1.0 but 60% if DRI > 2.0.

 


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