%0 Journal Article
%A Caso Maestro, Óscar
%A Jiménez Romero, Luis Carlos
%A Justo Alonso, Iago
%A Calvo Pulido, Jorge
%A Lora Pablos, David
%A Marcacuzco Quinto, Alberto Alejandro
%A Cambra Molero, Félix
%A García-Sesma Pérez-Fuentes, Álvaro
%A Pérez Flecha, Marina
%A Muñoz Arce, Carlos
%A Loinaz Segurola, Carmelo
%A Manrique Municio, Alejandro
%T Analyzing predictors of graft survival in patients undergoing liver transplantation with donors aged 70 years and over
%D 2018
%@ 1007-9327
%U https://hdl.handle.net/20.500.14352/99983
%X AIMTo increase the number of available grafts.METHODSThis is a single-center comparative analysis performed between April 1986 and May 2016. Two hundred and twelve liver transplantation (LT) were performed with donors ≥ 70 years old (study group). Then, we selected the first cases that were performed with donors < 70 years old immediately after the ones that were performed with donors ≥ 70 years old (control group).RESULTSGraft and patient survivals were similar between both groups without increasing the risk of complications, especially primary non-function, vascular complications and biliary complications. We identified 5 risk factors as independent predictors of graft survival: recipient hepatitis C virus (HCV)-positivity [hazard ratio (HR) = 2.35; 95% confidence interval (CI): 1.55-3.56; P = 0.00]; recipient age (HR = 1.04; 95%CI: 1.02-1.06; P = 0.00); donor age X model for end-stage liver disease (D-MELD) (HR = 1.00; 95%CI: 1.00-1.00; P = 0.00); donor value of serum glutamic-pyruvic transaminase (HR = 1.00; 95%CI: 1.00-1.00; P = 0.00); and donor value of serum sodium (HR = 0.96; 95%CI: 0.94-0.99; P = 0.00). After combining D-MELD and recipient age we obtained a new scoring system that we called DR-MELD (donor age X recipient age X MELD). Graft survival significantly decreased in patients with a DR-MELD score ≥ 75000, especially in HCV patients (77% vs 63% at 5 years in HCV-negative patients, P = 0.00; and 61% vs 25% at 5 years in HCV-positive patients; P = 0.00).
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