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Liver Transplant Recipient Characteristics Associated With Worse Post-Transplant Outcomes in Using Elderly Donors

Advanced age of liver donor is a risk factor for graft loss after transplant. We sought to identify recipient characteristics associated with negative post-liver transplant (LT) outcomes in the context of elderly donors. Using 2014–2019 OPTN/UNOS data, LT recipients were classified by donor age: ≥70...

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Autores principales: Shimada, Shingo, Shamaa, Tayseer, Ivanics, Tommy, Kitajima, Toshihiro, Collins, Kelly, Rizzari, Michael, Yoshida, Atsushi, Abouljoud, Marwan, Moonka, Dilip, Lu, Mei, Nagai, Shunji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9452632/
https://www.ncbi.nlm.nih.gov/pubmed/36090776
http://dx.doi.org/10.3389/ti.2022.10489
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author Shimada, Shingo
Shamaa, Tayseer
Ivanics, Tommy
Kitajima, Toshihiro
Collins, Kelly
Rizzari, Michael
Yoshida, Atsushi
Abouljoud, Marwan
Moonka, Dilip
Lu, Mei
Nagai, Shunji
author_facet Shimada, Shingo
Shamaa, Tayseer
Ivanics, Tommy
Kitajima, Toshihiro
Collins, Kelly
Rizzari, Michael
Yoshida, Atsushi
Abouljoud, Marwan
Moonka, Dilip
Lu, Mei
Nagai, Shunji
author_sort Shimada, Shingo
collection PubMed
description Advanced age of liver donor is a risk factor for graft loss after transplant. We sought to identify recipient characteristics associated with negative post-liver transplant (LT) outcomes in the context of elderly donors. Using 2014–2019 OPTN/UNOS data, LT recipients were classified by donor age: ≥70, 40–69, and <40 years. Recipient risk factors for one-year graft loss were identified and created a risk stratification system and validated it using 2020 OPTN/UNOS data set. At transplant, significant recipient risk factors for one-year graft loss were: previous liver transplant (adjusted hazard ratio [aHR] 4.37, 95%CI 1.98–9.65); mechanical ventilation (aHR 4.28, 95%CI 1.95–9.43); portal thrombus (aHR 1.87, 95%CI 1.26–2.77); serum sodium <125 mEq/L (aHR 2.88, 95%CI 1.34–6.20); and Karnofsky score 10–30% (aHR 2.03, 95%CI 1.13–3.65), 40–60% (aHR 1.65, 95%CI 1.08–2.51). Using those risk factors and multiplying HRs, recipients were divided into low-risk (n = 931) and high-risk (n = 294). Adjusted risk of one-year graft loss in the low-risk recipient group was similar to that of patients with younger donors; results were consistent using validation dataset. Our results show that a system of careful recipient selection can reduce the risks of graft loss associated with older donor age.
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spelling pubmed-94526322022-09-09 Liver Transplant Recipient Characteristics Associated With Worse Post-Transplant Outcomes in Using Elderly Donors Shimada, Shingo Shamaa, Tayseer Ivanics, Tommy Kitajima, Toshihiro Collins, Kelly Rizzari, Michael Yoshida, Atsushi Abouljoud, Marwan Moonka, Dilip Lu, Mei Nagai, Shunji Transpl Int Health Archive Advanced age of liver donor is a risk factor for graft loss after transplant. We sought to identify recipient characteristics associated with negative post-liver transplant (LT) outcomes in the context of elderly donors. Using 2014–2019 OPTN/UNOS data, LT recipients were classified by donor age: ≥70, 40–69, and <40 years. Recipient risk factors for one-year graft loss were identified and created a risk stratification system and validated it using 2020 OPTN/UNOS data set. At transplant, significant recipient risk factors for one-year graft loss were: previous liver transplant (adjusted hazard ratio [aHR] 4.37, 95%CI 1.98–9.65); mechanical ventilation (aHR 4.28, 95%CI 1.95–9.43); portal thrombus (aHR 1.87, 95%CI 1.26–2.77); serum sodium <125 mEq/L (aHR 2.88, 95%CI 1.34–6.20); and Karnofsky score 10–30% (aHR 2.03, 95%CI 1.13–3.65), 40–60% (aHR 1.65, 95%CI 1.08–2.51). Using those risk factors and multiplying HRs, recipients were divided into low-risk (n = 931) and high-risk (n = 294). Adjusted risk of one-year graft loss in the low-risk recipient group was similar to that of patients with younger donors; results were consistent using validation dataset. Our results show that a system of careful recipient selection can reduce the risks of graft loss associated with older donor age. Frontiers Media S.A. 2022-08-25 /pmc/articles/PMC9452632/ /pubmed/36090776 http://dx.doi.org/10.3389/ti.2022.10489 Text en Copyright © 2022 Shimada, Shamaa, Ivanics, Kitajima, Collins, Rizzari, Yoshida, Abouljoud, Moonka, Lu and Nagai. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Shimada, Shingo
Shamaa, Tayseer
Ivanics, Tommy
Kitajima, Toshihiro
Collins, Kelly
Rizzari, Michael
Yoshida, Atsushi
Abouljoud, Marwan
Moonka, Dilip
Lu, Mei
Nagai, Shunji
Liver Transplant Recipient Characteristics Associated With Worse Post-Transplant Outcomes in Using Elderly Donors
title Liver Transplant Recipient Characteristics Associated With Worse Post-Transplant Outcomes in Using Elderly Donors
title_full Liver Transplant Recipient Characteristics Associated With Worse Post-Transplant Outcomes in Using Elderly Donors
title_fullStr Liver Transplant Recipient Characteristics Associated With Worse Post-Transplant Outcomes in Using Elderly Donors
title_full_unstemmed Liver Transplant Recipient Characteristics Associated With Worse Post-Transplant Outcomes in Using Elderly Donors
title_short Liver Transplant Recipient Characteristics Associated With Worse Post-Transplant Outcomes in Using Elderly Donors
title_sort liver transplant recipient characteristics associated with worse post-transplant outcomes in using elderly donors
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9452632/
https://www.ncbi.nlm.nih.gov/pubmed/36090776
http://dx.doi.org/10.3389/ti.2022.10489
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