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oai:docta.ucm.es:20.500.14352/999832025-03-18T12:40:38Zcom_20.500.14352_14col_20.500.14352_15

00925njm 22002777a 4500 dc Caso Maestro, Óscar author Jiménez Romero, Luis Carlos author Justo Alonso, Iago author Calvo Pulido, Jorge author Lora Pablos, David author Marcacuzco Quinto, Alberto Alejandro author Cambra Molero, Félix author García-Sesma Pérez-Fuentes, Álvaro author Pérez Flecha, Marina author Muñoz Arce, Carlos author Loinaz Segurola, Carmelo author Manrique Municio, Alejandro author 2018-12-21 AIM To increase the number of available grafts. METHODS This 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). RESULTS Graft 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). 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 1007-9327 10.3748/wjg.v24.i47.5391 https://hdl.handle.net/20.500.14352/99983 https://www.wjgnet.com/1007-9327/full/v24/i47/5391.htm https://pubmed.ncbi.nlm.nih.gov/30598583/ Analyzing predictors of graft survival in patients undergoing liver transplantation with donors aged 70 years and over