Aims The aim of the study was to determine whether donor liver apoptosis is predictive for early allograft dysfunction (EAD) and graft survival after liver transplantation (LT).

Methods 159 specimens from donor livers at the end of cold ischemia were analyzed for apoptosis by TUNEL assays. Univariate and multivariate logistic regression models were used to identify prognostic factors for the occurrence of EAD. A nomogram was developed based on the independent risk factors.

Results The apoptosis index of donor liver in patients with EAD was significantly higher than that in patients with non-EAD (6.2±3.2 vs. 3.3±1.9, p<0.001). Univariate and multivariate logistic regression analysis identified apoptosis index of donor liver, donor age and gender, donor serum total bilirubin lever pre-transplant, MELD score and CIT were independent predictors for EAD. A nomogram was built on the predictor variables which showed good calibration and discriminatory ability with c-index value of 0.847 (95% CI, 0.839-0.853). The apoptosis indexes of donor livers in patients with graft loss within 30 days after LT were significant higher than that in patients without graft loss (6.1, 3.0 vs. 4.1, 3.6, p=0.011). 30 days graft survival rates in high apoptosis index (apoptosis index >4.4%) group patients were significantly lower than that in low apoptosis index (apoptosis index ≤ 4.4%) group (84.4% vs. 97.6%, p=0.004).

Conclusions Donor liver apoptosis plays a significant role in predicting EAD after LT. Furthermore, high apoptosis index of donor liver was associated with inferior graft survival on the short term.

CITATION INFORMATION: Guo Z., Zhu Z., Tang Y., Huang S., Zhang Z., He X., Chen G. Donor Liver Apoptosis is Associated with Early Allograft Dysfunction and Short-Time Graft Survival after Liver Transplantation Am J Transplant. 2017;17 (suppl 3).

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