Donor risk index predicts graft failure reliably but not post-transplant infections
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 collec...
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Published in | Surgical infections Vol. 15; no. 2; p. 94 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
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United States
01.04.2014
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Abstract | 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. |
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AbstractList | 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. |
Author | Schmitt, Timothy M Gillen, Jacob R Kumer, Sean C Brayman, Kenneth L Sawyer, Robert G Hranjec, Tjasa Stokes, Jayme B Rosenberger, Laura H |
Author_xml | – sequence: 1 givenname: Laura H surname: Rosenberger fullname: Rosenberger, Laura H organization: 1 Department of Surgery, University of Virginia Health System , Charlottesville, Virginia – sequence: 2 givenname: Jacob R surname: Gillen fullname: Gillen, Jacob R – sequence: 3 givenname: Tjasa surname: Hranjec fullname: Hranjec, Tjasa – sequence: 4 givenname: Jayme B surname: Stokes fullname: Stokes, Jayme B – sequence: 5 givenname: Kenneth L surname: Brayman fullname: Brayman, Kenneth L – sequence: 6 givenname: Sean C surname: Kumer fullname: Kumer, Sean C – sequence: 7 givenname: Timothy M surname: Schmitt fullname: Schmitt, Timothy M – sequence: 8 givenname: Robert G surname: Sawyer fullname: Sawyer, Robert G |
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CitedBy_id | crossref_primary_10_1016_j_transproceed_2023_02_052 crossref_primary_10_1117_1_JBO_23_8_080601 crossref_primary_10_1002_lt_24799 crossref_primary_10_1080_24725854_2024_2321492 crossref_primary_10_1371_journal_pone_0214221 crossref_primary_10_1111_ctr_14419 |
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SubjectTerms | 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 |
Title | Donor risk index predicts graft failure reliably but not post-transplant infections |
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