RT Journal Article
T1 Analyzing predictors of graft survival in patients undergoing liver transplantation with donors aged 70 years and over
A1 Caso Maestro, Óscar
A1 Jiménez Romero, Luis Carlos
A1 Justo Alonso, Iago
A1 Calvo Pulido, Jorge
A1 Lora Pablos, David
A1 Marcacuzco Quinto, Alberto Alejandro
A1 Cambra Molero, Félix
A1 García-Sesma Pérez-Fuentes, Álvaro
A1 Pérez Flecha, Marina
A1 Muñoz Arce, Carlos
A1 Loinaz Segurola, Carmelo
A1 Manrique Municio, Alejandro
AB 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).
PB https://pubmed.ncbi.nlm.nih.gov/30598583/
SN 1007-9327
YR 2018
FD 2018-12-21
LK https://hdl.handle.net/20.500.14352/99983
UL https://hdl.handle.net/20.500.14352/99983
LA eng
NO Caso-Maestro O, Jiménez-Romero C, Justo-Alonso I, Calvo-Pulido J, Lora-Pablos D, Marcacuzco-Quinto A, Cambra-Molero F, García-Sesma A, Pérez-Flecha M, Muñoz-Arce C, Loinaz-Segurola C, Manrique-Municio A. Analyzing predictors of graft survival in patients undergoing liver transplantation with donors aged 70 years and over. World J Gastroenterol. 2018 Dec 21;24(47):5391-5402. doi: 10.3748/wjg.v24.i47.5391
DS Docta Complutense
RD 7 abr 2025