Donor risk index predicts graft failure reliably but not post-transplant infections

• Published in: Surgical infections Vol. 15; no. 2; p. 94
• Main Authors: Rosenberger, Laura H, Gillen, Jacob R, Hranjec, Tjasa, Stokes, Jayme B, Brayman, Kenneth L, Kumer, Sean C, Schmitt, Timothy M, Sawyer, Robert G
• Format: Journal Article
• Language: English
• Published: United States 01.04.2014
• Subjects: Adolescent; Adult; Aged; Child; Graft Survival; Humans; Kidney Transplantation - adverse effects; Liver Transplantation - adverse effects; Liver Transplantation - statistics & numerical data; Middle Aged; Postoperative Complications - etiology; Prospective Studies; Risk Factors; Tissue Donors; Young Adult
• ISSN: 1557-8674
• DOI: 10.1089/sur.2013.035

The Donor Risk Index (DRI) is used to predict graft survival following liver transplantation, but has not been used to predict post-operative infections in graft recipients. We hypothesized that lower-quality grafts would result in more frequent infectious complications. Using a prospectively collected infection data set, we matched liver transplant recipients (and the respective allograft DRI scores) with their specific post-transplant infectious complications. All transplant recipients were organized by DRI score and divided into groups with low-DRI and high-DRI scores. We identified 378 liver transplants, with 189 recipients each in the low-DRI and high-DRI groups. The mean DRI scores for the low- and high-DRI-score groups were 1.14±0.01 and 1.74±0.02, respectively (p<0.0001 for the difference). The mean Model for End-Stage Liver Disease (MELD) scores were 26.25±0.53 and 24.76±0.55, respectively (p=0.052), and the mean number of infectious complications per patient were 1.60±0.19 and 1.94±0.24, respectively (p=0.26). Logistic regression showed only length of hospital stay and a history of vascular disease as being associated independently with infection, with a trend toward significance for MELD score (p=0.13). We conclude that although DRI score predicts graft-liver survival, infectious complications depend more heavily on recipient factors.