Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Dec:48:42-47.
doi: 10.1016/j.jcrc.2018.08.013. Epub 2018 Aug 18.

Donor biomarkers as predictors of organ use and recipient survival after neurologically deceased donor organ transplantation

Shengnan Li  1 , Shu Wang  2 , Raghavan Murugan  3 , Ali Al-Khafaji  3 , Daniel J Lebovitz  4 , Michael Souter  5 , Susan R N Stuart  6 , John A Kellum  7 ; Monitoring Organ Donors to Improve Transplantation Results (MOnIToR) Study Investigators
Affiliations

Donor biomarkers as predictors of organ use and recipient survival after neurologically deceased donor organ transplantation

Shengnan Li et al. J Crit Care. 2018 Dec.

Abstract

Purpose: We sought to build prediction models for organ transplantation and recipient survival using both biomarkers and clinical information.

Materials and methods: We abstracted clinical variables from a previous randomized trial (n = 556) of donor management. In a subset of donors (n = 97), we measured two candidate biomarkers in plasma at enrollment and just prior to explantation.

Results: Secretory leukocyte protease inhibitor (SLPI) was significant for predicting liver transplantation (C-statistic 0.65 (0.53, 0.78)). SLPI also significantly improved the predictive performance of a clinical model for liver transplantation (integrated discrimination improvement (IDI): 0.090 (0.009, 0.210)). For other organs, clinical variables alone had strong predictive ability (C-statistic >0.80). Recipient 3-years survival was 80.0% (71.9%, 87.0%). Donor IL-6 was significantly associated with recipient 3-years survival (adjusted Hazard Ratio (95%CI): 1.26(1.08, 1.48), P = .004). Neither clinical variables nor biomarkers showed strong predictive ability for 3-year recipient survival.

Conclusions: Plasma biomarkers in neurologically deceased donors were associated with organ use. SLPI enhanced prediction within a liver transplantation model, whereas IL-6 before transplantation was significantly associated with recipient 3-year survival. Clinicaltrials.gov: NCT00987714.

Keywords: Biomarker; Brain death; Clinical trial; Organ donation; Risk prediction; Transplantation.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Study flow and cohort selection.
Out of 556 neurologically deceased organ donors, 505 donors had complete clinical data. From four clinical data sites, we collected plasma analysis (n=120). After excluding missing or aborted data (n=23), 97 donors containing both complete clinical and biomarker information were included in our final data set.
See this image and copyright information in PMC

References

    1. http://www.americantransplantfoundation.org/about-transplant/facts-and-m..., n.d, 2017.
    1. Israni AK, Zaun D, Rosendale JD, et al. 2012 Annual Data Report: deceased organ donation. Am J Transplant 2014; 1:167–183. - PubMed
    1. Lima B, Rajagopal K, Petersen RP, et al. Marginal cardiac allografts do not have increased primary graft dysfunction in alternate list transplantation. Circulation 2006; 114:I27–32. - PubMed
    1. Maciel CB, Greer D. ICU Management of the Potential Organ Donor: State of the Art. Curr Neurol Neurosci Rep 2016; 16:86. - PubMed
    1. Pullerits R, Oltean S, Flodén A, et al. Circulating resistin levels are early and significantly increased in deceased brain dead organ donors, correlate with inflammatory cytokine response and remain unaffected by steroid treatment. J Transl Med 2015; 13:201. - PMC - PubMed

Publication types

Associated data