Analysis of donor criteria for the prediction of outcome in clinical liver transplantation

Abstract

The results of 219 orthotopic human liver transplants performed during 1985 at the University of Pittsburgh were reviewed to determine whether donor parameters could be used to predict the quality of early graft function. Multivariate discriminant analysis demonstrated that traditional parameters of donor assessment are unreliable predictors of poor graft function. Furthermore, 56% of the donors considered poor by conservative selection criteria produced livers with good early posttransplant function. Survival of recipients of primary allografts from donors rated poor was no different than survival of recipients of allografts from donors rated good.

Fig 1

The causes of death for 219 liver allograft donors.

Fig 2

Scatterplots of early graft outcome (G, good; F, fair; P, poor) based on donor liver function tests. Results predicted by discriminant analysis model are compared with actual results.

Fig 3

Scatterplots of early graft outcome (G, good; F, fair; P, poor) based on donor arterial blood gases. Results predicted by discriminant analysis model compared with actual results.

Fig 4

Scatterplots of early graft outcome (G, good; F, fair; P, poor) based on donor blood pressure, cause of death, and total ischemic time. Results predicted by discriminant analysis model are compared with actual results.

Fig 5

Patient survival for recipients of primary liver transplants classified by donor rating. There was no significant difference in survival between recipients of allografts from donors rated good and those rated poor.