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. 2023 Apr 7:28:e939060.
doi: 10.12659/AOT.939060.

Postoperative Outcomes in 415 Patients Following Liver Transplantation Using Extended Donor Criteria: A Study from a Single Center in Germany

Aladdin Ali Deeb  1 , Utz Settmacher  1 , Johannes Fritsch  1 , Felix Dondorf  1 , Oliver Rohland  1 , Falk Rauchfuß  1
Affiliations

Postoperative Outcomes in 415 Patients Following Liver Transplantation Using Extended Donor Criteria: A Study from a Single Center in Germany

Aladdin Ali Deeb et al. Ann Transplant. .

Abstract

BACKGROUND Because of the massive organ shortage worldwide, marginal organs are increasingly being considered. The aim of this study was to present a comprehensive analysis of donor-related factors clinically supposed to influence the outcome after liver transplantation. This study from a single center in Germany aimed to evaluate postoperative outcomes in 415 patients following liver transplantation using extended donor criteria. MATERIAL AND METHODS Extended donor criteria (EDC) were considered according to the official guidelines issued through the German Medical Association. Other factors and the Eurotransplant Donor Risk Index (ET-DRI) were also considered. Correlation studies, logistic regression, and Kaplan-Meier-estimator were used to evaluate the outcome. RESULTS The postoperative outcomes with or without EDC were comparable. Other factors had an impact on early allograft failure (EAD), including male donors (χ²=14.135, P=0.0001). Other donor-unrelated factors, like cold ischemia time, also had an impact on EAD (r=0.135, P=0.010), especially in patients with model for end-stage liver disease (MELD) <25 (ß=0.001, P=0.008). ET-DRI was a crucial factor in estimating overall and allograft survival after liver transplantation. CONCLUSIONS The findings from this study support the possibility of liver transplantation using organs obtained by EDC. Other factors, like donor sex and cold ischemic time, are not part of the EDC, although they have an impact on EAD. Organs obtained by EDC continue to be an option to address the organ shortage.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1
Figure 1
Flowchart showing the cohort derivation. EDC – extended donor criteria; HU – high urgency. Lucidchart: https://www.lucidchart.com/pages/examples/flowchart-maker.
Figure 2
Figure 2
Impact pf early allograft dysfunction (EAD) on organ survival (P=0.003). EAD – early allograft dysfunction. IBM SPSS Statistics Version: 25.0.0.0 (IBM, Armonk, New York, USA).
Figure 3
Figure 3
Distribution of EDC score in the different MRLD categories: Category 1: MELD ≤10; Category 2: MELD ≥11 to 18; Category 3: MELD ≥19 to 24; Category 4: MELD ≥25. EDC – extended donor criteria; MELD – model for end-stage liver disease. IBM SPSS Statistics Version: 25.0.0.0 (IBM, Armonk, New York, USA).
Figure 4
Figure 4
Overall survival in comparison based on Eurotransplant Donor Risk index (ET-DRI). IBM SPSS Statistics Version: 25.0.0.0 (IBM, Armonk, New York, USA).
Figure 5
Figure 5
Organ survival in comparison based on Eurotransplant Donor Risk Index (ET-DRI). IBM SPSS Statistics Version: 25.0.0.0 (IBM, Armonk, New York, USA).
See this image and copyright information in PMC

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