Predicting Liver Allograft Discard: The Discard Risk Index

Transplantation
Abbas RanaJohn A Goss

Abstract

An index that predicts liver allograft discard can effectively grade allografts and can be used to preferentially allocate marginal allografts to aggressive centers. The aim of this study is to devise an index to predict liver allograft discard using only risk factors available at the time of initial DonorNet offer. Using univariate and multivariate analyses on a training set of 72 297 deceased donors, we identified independent risk factors for liver allograft discard. Multiple imputation was used to account for missing variables. We identified 15 factors as significant predictors of liver allograft discard; the most significant risk factors were: total bilirubin > 10 mg/dL (odds ratio [OR], 25.23; confidence interval [CI], 17.32-36.77), donation after circulatory death (OR, 14.13; CI, 13.30-15.01), and total bilirubin 5 to 10 mg/dL (OR, 7.57; 95% CI, 6.32-9.05). The resulting Discard Risk Index (DSRI) accurately predicted the risk of liver discard with a C statistic of 0.80. We internally validated the model with a validation set of 37 243 deceased donors and also achieved a 0.80 C statistic. At a DSRI at the 90th percentile, the discard rate was 50% (OR, 32.34; CI, 28.63-36.53), whereas at a DSRI at 10th percentile, only 3% o...Continue Reading

References

Apr 2, 2003·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Giulio MarchesiniMario Rizzetto
Apr 29, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Akinlolu O OjoRobert A Metzger
Nov 27, 2004·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jeffrey D BrowningHelen H Hobbs
Mar 17, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·S FengR M Merion
Jan 30, 2007·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Tadahiro UemuraGoran B Klintmalm
Dec 4, 2008·The Journal of Clinical Endocrinology and Metabolism·Giulio MarchesiniGabriele Forlani
Feb 5, 2009·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·L M KucirkaD L Segev
May 30, 2009·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Richard S MangusA Joseph Tector
May 5, 2010·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·John F Renz
Dec 1, 2010·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·John F Renz
Dec 15, 2010·Journal of Hepatology·Lucas McCormackPierre-Alain Clavien
May 24, 2011·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Deepak K OzhathilShimul A Shah
Jan 31, 2012·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Sanjeev K AkkinaAjay K Israni
Dec 21, 2012·Current Opinion in Organ Transplantation·Manuel MaglionePeter J Friend
Feb 15, 2013·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Hasan YersizHenrik Petrowsky
Mar 1, 2013·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Jennifer C LaiJohn P Roberts
May 23, 2013·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Milan KinkhabwalaPaul J Gaglio
Jan 30, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·B TanrioverM A Hardy
Oct 14, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·D GhinolfiF Filipponi

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Citations

Feb 9, 2020·Clinical Transplantation·Abbas RanaJohn A Goss
Mar 22, 2020·Clinical Transplantation·Abbas RanaJohn Goss
Aug 11, 2020·JAMA Surgery·Theodore ZhangAbbas Rana
Jul 20, 2019·Transplantation Direct·Jacob D de BoerAndries E Braat
Jan 7, 2021·Pediatric Transplantation·Tahir MalikAbbas Rana
May 19, 2020·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Nikole A NeidlingerGarrett R Roll
Sep 17, 2020·JAMA Surgery·Theodore ZhangAbbas Rana
Mar 18, 2021·Progress in Transplantation : Official Publication, North American Transplant Coordinators Organization ... [et Al.]·Theodore ZhangAbbas Rana
Jul 29, 2021·Clinical Transplantation·Ross M ReulAbbas A Rana
Jul 22, 2021·Transplant International : Official Journal of the European Society for Organ Transplantation·Rafaela CapelliMarc-Antoine Allard
Nov 24, 2021·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Jacob D de BoerE L I A C Advisory Committee
Dec 3, 2021·Clinical Transplantation·Cameron GoffAbbas Rana

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