Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2009-6-3
pubmed:abstractText
We have investigated the impact of the donor risk index (DRI) on the outcome of hepatitis C virus (HCV)-infected patients undergoing liver transplantation (LTx). Retrospective analysis was performed from the Organ Procurement and Transplantation Network database (January 1, 2000 to June, 2006). The DRI was calculated as described by Feng et al. (Am J Transplant 2006;6:783-790). Model for End-Stage Liver Disease (MELD) exceptions were excluded from the analysis. Relative risk (RR) estimates of patient and graft loss were derived from Cox regression models. The Wald test was used to test the effect of the MELD score at transplant on the HCV-DRI interaction. Of the LTx recipients (16,678), 76.1% were Caucasian, and 66.7% were male; the median age was 52 (range, 18-80 years), and the mean follow-up time was 1148 days (range, 0-2959 days). Forty-six percent (n = 7675) of LTx recipients were HCV(+). The median DRI was 1.3 (range, 0.77-4.27). Increasing DRI was associated with a statistically significant increase in the RR of graft failure and patient death for both HCV(+) and HCV(-) recipients. However, HCV(+) recipients demonstrated a significantly higher increase in the RR of patient and graft loss as a function of the DRI than HCV(-) subjects, even after adjustments for several recipient factors, including MELD. In conclusion, a synergistic interaction between donor DRI and recipient HCV status exists, such that an allograft from a high-DRI donor more adversely affects the outcome of an HCV(+) recipient than that of an HCV(-) recipient.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
1527-6473
pubmed:author
pubmed:copyrightInfo
(c) 2009 AASLD.
pubmed:issnType
Electronic
pubmed:volume
15
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
592-9
pubmed:meshHeading
pubmed-meshheading:19479802-Adolescent, pubmed-meshheading:19479802-Adult, pubmed-meshheading:19479802-Aged, pubmed-meshheading:19479802-Aged, 80 and over, pubmed-meshheading:19479802-Female, pubmed-meshheading:19479802-Follow-Up Studies, pubmed-meshheading:19479802-Graft Rejection, pubmed-meshheading:19479802-Hepatitis C, pubmed-meshheading:19479802-Humans, pubmed-meshheading:19479802-Liver, pubmed-meshheading:19479802-Liver Transplantation, pubmed-meshheading:19479802-Male, pubmed-meshheading:19479802-Middle Aged, pubmed-meshheading:19479802-Patient Selection, pubmed-meshheading:19479802-Proportional Hazards Models, pubmed-meshheading:19479802-Retrospective Studies, pubmed-meshheading:19479802-Risk Factors, pubmed-meshheading:19479802-Severity of Illness Index, pubmed-meshheading:19479802-Tissue Donors, pubmed-meshheading:19479802-Treatment Outcome, pubmed-meshheading:19479802-Young Adult
pubmed:year
2009
pubmed:articleTitle
Impact of the donor risk index on the outcome of hepatitis C virus-positive liver transplant recipients.
pubmed:affiliation
Division of Transplantation Surgery, Virginia Commonwealth University, Richmond, VA 23298-0248, USA. dgmaluf@vcu.edu
pubmed:publicationType
Journal Article