Description

Schlegel et al developed the UK-DCD risk score to identify outcomes following transplant of a donor after cardiac death (DCD). This help to identify a patient who may not benefit from the transplant. The authors are from Queen Elizabeth University Hospital Birmingham and University Hospital Zurich.


Patient selection: liver transplant recipient receiving liver transplant after circulatory death

 

Parameters:

(1) donor age

(2) donor body mass index (BMI) in kg per square meter

(3) functional donor warm ischemia in time in minutes

(4) cold ischemia time in hours

(5) recipient's age in years

(6) recipient laboratory MELD score (without inclusion of exception points for hepatocellular cancer)

(7) retransplantation

 

Parameter

Finding

Points

donor age

<= 60 years

0

 

> 60 years

2

donor BMI

<= 25 kg per sq m

0

 

> 25 kg per sq m

3

warm ischemia time

<= 20 minutes

0

 

20.1 to 30 minutes

3

 

> 30 minutes

6

cold ischemia time

<= 6 hours

0

 

> 6 hours

2

recipient's age

<= 60 years

0

 

> 60 years

3

recipient's lab MELD

<= 25 points

0

 

> 25 points

2

retransplantation

no

0

 

yes

9

 

total score =

= SUM(points for all 7 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 27

• The higher the score the worse the prognosis with risk of mortality and/or graft loss.

 

Score

5-Year Survival

Risk Group

0 to 5

85%

low

6 to 10

56%

high

11 to 27

15%

futile (very high)

 

Performance:

• The area under the ROC curve was 0.79.


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