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. 2022 Dec;22(12):2921-2930.
doi: 10.1111/ajt.17191. Epub 2022 Sep 22.

Assessment of donor quality and risk of graft failure after liver transplantation: The ID2 EAL score

Sumeet K Asrani  1 , Giovanna Saracino  1 , Anji Wall  1 , James F Trotter  1 , Giuliano Testa  1 , Ruben Hernaez  2 , Pratima Sharma  3 , Allison Kwong  4 , Srikanta Banerjee  5 , Gregory McKenna  1
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Free article

Assessment of donor quality and risk of graft failure after liver transplantation: The ID2 EAL score

Sumeet K Asrani et al. Am J Transplant. 2022 Dec.
Free article

Abstract

Accurate assessment of donor quality at the time of organ offer for liver transplantation candidates may be inadequately captured by the donor risk index (DRI). We sought to develop and validate a novel objective and simple model to assess donor risk using donor level variables available at the time of organ offer. We utilized national data from candidates undergoing primary LT (2013-2019) and assessed the prediction of graft failure 1 year after LT. The final components were donor Insulin-dependent diabetes mellitus, Donor type (DCD or DBD), cause of Death = CVA, serum creatinine, Age, height, and weight (length). The ID2 EAL score had better discrimination than DRI using bootstrap corrected concordant index over time, especially in the current era. We explored donor-recipient matching. Relative risk of graft failure ranged from 1.15 to 3.5 based on relevant donor-recipient matching by the ID2 EAL score. As an example, for certain recipients, a young DCD donor offer was preferable to an older DBD with relevant comorbidities. The ID2 EAL score may serve as an important tool for patient discussion about donor risk and decisions regarding offer acceptance. In addition, the score may be preferable to succinctly capture donor risk in future organ allocation that considers continuous distribution (www.iddealscore.com).

Keywords: DCD; donor risk index; graft failure; graft survival; mortality; prediction model.

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References

REFERENCES

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