Matching donors and recipients

This study identifies the major risk factors associated with outcome after liver transplantation, showing that candidates for this surgery can be stra tified into differential risk categories at the time of the actual surgery. All the livers used were flushed with University of Wisconsin solution. Th e study is a retrospective multivariate analysis of 2376 consecutive transp lantations performed on 2019 recipients between November 1, 1987, and Decem ber 31, 1993. Donor variables studied were age, sex, blood type, cause of d eath, intensive care unit length of stay, body mass index, use of pressors (dopamine infusion >10 mu g/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 fo r liver transplantation; history of liver transplantation or upper abdomina l surgery; United Network for Organ Sharing urgency status; need for mechan ical ventilation; primary immunosuppression; and preoperative bilirubin lev el, prothrombin time, and creatinine level. The Variables independently ass ociated with outcome were donor age, female donor sex, ischemia time, recip ient age, prior liver transplant, preoperative mechanical ventilation, preo perative bilirubin level, preoperative creatinine level, indication for tra nsplantation, 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 resul ts across different groups or in helping to choose the best donor-recipient combination based on the calculated probability of a favorable outcome. Co pyright (C) 1998 by the American Association for the Study of Liver Disease s.