Study: Three Factors Determine Liver Transplant Survival
Donor age, patient's need and organ cooling period are key
TUESDAY, March 22, 2005 (HealthDay News) -- Donor age, the urgency of the recipient's need, and the length of time a donated liver is cooled between procurement and transplant are the three major factors driving the success or failure of liver transplantation, a new study finds.
A model that included these three variables "could be used to make recipient-specific organ allocation decisions" before transplant, researchers at Vanderbilt University Medical Center in Nashville, Tenn., said in a prepared statement.
Reporting in the March issue of the Archives of Surgery, the researchers analyzed data on all adult patients who had a liver transplant for end-stage liver disease at Vanderbilt between 1991 and mid-2003.
They concluded that a donor age of 60 years and older, a cooling interval (clinically called 'cold ischemia time') of 12 hours or more, and urgent recipient need were independent risk factors that reduced both transplant and patient survival.
For example, "five-year graft survival was 72 percent for recipients of donors younger than 60 years and 35 percent for recipients of donors 60 years or older," the study authors wrote, while an organ cooling period of "12 hours or more was [also] associated with shorter five-year graft survival."
Based on these types of findings, they estimate that an organ from a young donor transplanted into a relatively healthy recipient within 12 hours of cooling "would have a probability of 75 percent of surviving for five years."
In contrast, a urgent-need patient receiving an organ from a donor 60 years of age or older, transplanted beyond the 12-hour cooling limit "would have only a 20 percent probability of surviving five years after the transplant," they wrote.
Each year in the United States, about 2,000 people with end-stage liver disease die while waiting for a suitable donor liver. In 2000, there were about 17,000 patients waiting for a liver transplant and about 5,000 liver transplantations.
To increase the number of liver transplants, livers that are less than optimum are being considered for possible transplant. Identifying the factors that have the greatest influence on graft and patients survival rates could help increase the liver donor pool and shorten waiting times for liver transplantation.
The American Liver Foundation has more about liver transplants.