Donor Risk Index for Intestinal & Multi-Visceral Transplantation.
1Department of Pathology, The Thomas E Starzl Transplantation Institute, Pittsburgh, PA
2Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, PA
3Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
4Multi-Organ Transplant & Hepatobiliary, Westchester Medical Center, Valhalla, NY.
Meeting: 2016 American Transplant Congress
Abstract number: A302
Keywords: Intestinal transplantation, Risk factors
Session Information
Session Name: Poster Session A: Small Bowel: All Topics
Session Type: Poster Session
Date: Saturday, June 11, 2016
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Background: The Donor Risk Index and the Kidney Donor Profile Index (KDPI) have been utilized for liver and kidney transplantation in clinical and research setting. However, no donor risk index or scoring system has been developed for intestinal and multi-visceral transplantation. Here we proposed the donor risk index for intestinal and multi-visceral transplantation.
Methods: Retrospectively collected and analyzed data on 2,439 intestinal and multi-visceral transplant patients from the United Network for Organ Sharing (UNOS) from 1990 to 2014. The intestinal and multi-visceral transplant was categorized as three main types of visceral transplantation (I-intestine, II-liver-intestine, and III-multivisceral). Cox regression was used to model the risk of death or graft loss, based on donor and transplant factors, adjusting for recipient factors.
Results: Five donor characteristics and three recipient characteristics were identified for poor graft survival. The donor factors were race, weight, cause of death, total bilirubin, SGOT, and organ code. The three recipient factors were total bilirubin, hospitalized type, and albumin. Based on these risk factors, Donor risk index = exp[(0.206 if donor black) + (0.133*log(donor wgt in kg)) + (0.086 if donor COD=stroke) or (-0.116 if donor COD=head trauma) or (-0.329 if donor COD=cns tumor) + (0.082*log(donor tbili)) + (0.171 if donor GOT abnormal) + (0.042*log(rec tbili)) + (0.385 if rec is hospitalized not in ICU) or (0.602 if rec is in intensive care unit) + (-0.125*(rec album)) + (-0.347 if organ_code=2) or (-0.317 if organ_code=3.1) or (-0.102 if organ_code=3.2)]. Intestinal and multi-visceral transplant in the highest DRI quartile (1.23-<3.56) had an adjusted 5-year graft survival of 32%, compared with 61% in the lowest DRI quartile (0.42-<0.81, respectively).
Conclusions: An Intestinal Donor Risk Index based on five donor variables provides a useful decision-making tool at the time of organ allocation and organ acceptance.
CITATION INFORMATION: Zeng G, Chen M, Zhao X, Landsittel D, Sogawa H. Donor Risk Index for Intestinal & Multi-Visceral Transplantation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Zeng G, Chen M, Zhao X, Landsittel D, Sogawa H. Donor Risk Index for Intestinal & Multi-Visceral Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/donor-risk-index-for-intestinal-multi-visceral-transplantation/. Accessed May 11, 2025.« Back to 2016 American Transplant Congress