Matching donors and recipients. 1998

I R Marino, and C Doria, and H R Doyle, and T J Gayowski
Department of Surgery, Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, PA 15213, USA.

This study identifies the major risk factors associated with outcome after liver transplantation, showing that candidates for this surgery can be stratified into differential risk categories at the time of the actual surgery. All the livers used were flushed with University of Wisconsin solution. The study is a retrospective multivariate analysis of 2376 consecutive transplantations performed on 2019 recipients between November 1, 1987, and December 31, 1993. Donor variables studied were age, sex, blood type, cause of death, intensive care unit length of stay, body mass index, use of pressors (dopamine infusion > 10 micrograms/kg/min or continuous infusion of epinephrine or norepinephrine), use of pitressin, cardiopulmonary resuscitation, terminal transaminase levels, serum sodium level at procurement, and total ischemia time. Recipient variables studied were age; sex; blood type; indication for liver transplantation; history of liver transplantation or upper abdominal surgery; United Network for Organ Sharing urgency status; need for mechanical ventilation; primary immunosuppression; and preoperative bilirubin level, prothrombin time, and creatinine level. The variables independently associated with outcome were donor age, female donor sex, ischemia time, recipient age, prior liver transplant, preoperative mechanical ventilation, preoperative bilirubin level, preoperative creatine level, indication for transplantation and primary immunosuppression used. The results of this study not only give us insight into the probable outcomes of individual patients, but also show that this stratification can be useful when comparing results across different groups or in helping to choose the best donor-recipient combination based on the calculated probability of a favorable outcome.

UI MeSH Term Description Entries
D008297 Male Males
D008403 Mass Screening Organized periodic procedures performed on large groups of people for the purpose of detecting disease. Screening,Mass Screenings,Screening, Mass,Screenings,Screenings, Mass
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006085 Graft Survival The survival of a graft in a host, the factors responsible for the survival and the changes occurring within the graft during growth in the host. Graft Survivals,Survival, Graft,Survivals, Graft
D006648 Histocompatibility The degree of antigenic similarity between the tissues of different individuals, which determines the acceptance or rejection of allografts. HLA Incompatibility,Histoincompatibility,Human Leukocyte Antigen Incompatibility,Immunocompatibility,Tissue Compatibility,Compatibility, Tissue,HLA Incompatibilities,Histocompatibilities,Histoincompatibilities,Immunocompatibilities,Incompatibility, HLA,Tissue Compatibilities
D006650 Histocompatibility Testing Identification of the major histocompatibility antigens of transplant DONORS and potential recipients, usually by serological tests. Donor and recipient pairs should be of identical ABO blood group, and in addition should be matched as closely as possible for HISTOCOMPATIBILITY ANTIGENS in order to minimize the likelihood of allograft rejection. (King, Dictionary of Genetics, 4th ed) Crossmatching, Tissue,HLA Typing,Tissue Typing,Crossmatchings, Tissue,HLA Typings,Histocompatibility Testings,Testing, Histocompatibility,Testings, Histocompatibility,Tissue Crossmatching,Tissue Crossmatchings,Tissue Typings,Typing, HLA,Typing, Tissue,Typings, HLA,Typings, Tissue
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000367 Age Factors Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time. Age Reporting,Age Factor,Factor, Age,Factors, Age

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