Analysis of liver recipients survival with donor risk index (dri): a prospective study of cadaveric donors from OPO-HC-UNICAMP and their receptors

Resumen

Introduction: In 2006, a donor risk index (DRI) was published based on data such as age, race, height, cause of brain death, cardio respiratory arrest, split-organ and ischemia time. Purpose: To study the survival rate of liver recipient with DRI. Method: This is an analytic and prospective study. The characteristics from the liver donor were: age (years), race (white/ black/Asian), height (cm), cause of brain death (anoxia, trauma, stroke or tumor), presence of cardiac arrest, cold ischemia time and procurement place (local, regional or national). The liver recipients’ characteristics were: age (years), etiology of liver disease, MELD score (total bilirubin, creatinine and IRN), warm ischemia time (minutes), ICU time (days), pre- transplant renal injury (yes/no) and Child-Pugh classification. From April 2008 to May 2009 all consecutive 66 OLTs and their respective DRI were analyzed. Recipients were followed up for at least six months in order to evaluate statistically the association between recipient survival and DRI at our service. The Kaplan-Meier method was used to analyze survival rate (using the log-rank test) and the Cox regression test to identify predictive factors. Results: There was statistical difference in the cumulative proportion of survival according to the 1.7 >DRI>1.7 levels (P=0.03). Recipients with MELD> 24 had shorter survival rate (40%) than MELD ≤ 24 recipients (80%; P = 0.03) and the Cox regression test for survival time showed that patients with higher risk of death were: recipients with high values of MELD score and donor age with risk of death of 8% over 50 years; and DRI with 2% risk of death for each extra point. Conclusion: There was association between donor risk index and recipient survival. High MELD score values, DRI and donor age are variables that are found associated with the highest number of deaths and shorter survival.