Donor risk index variation of deceased donor in liver transplantation between offering OPO

Abstract

Introduction: Geographical disparities, quantity and quality of organs may result in different liver acceptance patterns among transplant teams. Purpose. To determine the standard quality of the organ in cadaveric liver transplantation, according to the region of the supply and the clinical status of the recipient. Methods: We used the variation of the donor risk index (DRI) of the 4 OPO in Paraná (Curitiba, Maringá, Londrina and Cascavel) and national OPO. The sample included all adults undergoing liver transplantation from deceased donor between November, 2015 and February 2019 (n=135), in a single center. Results: The mean DRI of patients was 1.37 (interquartile range [IIQ] 1.09-1.59). Mean DRI per offering OPO ranged from 1.26 to 1.76 (p<0.05). The average DRI (1.76) of organs offered by the National OPO exceeded the IIQ of the DRI of other OPOs. There was no difference in age (mean 50.4+11.54) and SOFA (mean 9.78+2.14). Time of cold ischemia of the national OPO (496+74.58 min) was significantly longer, but did not exceed 75% of other OPOs. Organ recipients offered by the National OPO had significantly lower MELD (18+4.78). Positive linear correlation between receptor MELD and DRI was observed, without attaining statistical significance. Conclusions: The mean DRI and its interquartile amplitude of organs accepted for transplantation in our service is similar to transplanted organs in the USA, Europe and Brazil. Patients with significantly lower MELD received organs with higher DRI.