Copyright
©The Author(s) 2024.
World J Gastrointest Surg. Feb 27, 2024; 16(2): 331-344
Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.331
Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.331
Table 1 Donor and graft characteristics
Variable | Value (n = 656) |
Male sex | 389 (59.3) |
Blood type | |
0 | 238 (36.3) |
A | 267 (40.7) |
B | 111 (16.9) |
AB | 40 (6.1) |
Pancreas offered (yes) | 145 (22.1) |
Cardiac arrest (yes) | 93 (14.2) |
Age (yr) | 60 (48-70) |
BMI (kg/m²) | 26.3 (24.4-28.4) |
ET-DRI | 1.72 (1.47-1.95) |
Steatosis (%) | 2 (0-10) |
Na (mEq/L) | 148 ± 9 (120-187) |
ALT (U/L) | 54.3 ± 79.6 (5-898) |
GGT (U/L) | 66.8 ± 99.8 (4-1129) |
Bilirubin (mg/dL) | 14 ± 12.6 (1-146) |
CRP (mg/L) | 162.6 ± 102.4 (1-621) |
CIT (h) | 7.11 ± 2.3 (1.22-13.87) |
Table 2 Recipient characteristics
Variable | Value (n = 656) |
Male sex | 469 (71.5) |
Blood type | |
0 | 212 (32.3) |
A | 267 (40.7) |
B | 124 (18.9) |
AB | 53 (8.1) |
Indication for LT | |
Alcoholic liver cirrhosis | 197 (30.03) |
Cancer (HCC, CCC) | 184 (28.05) |
Cholestatic liver disease | 53 (8.08) |
Hepatitis C virus | 41 (6.25) |
Retransplantation | 83 (12.65) |
Miscellaneous | 98 (14.94) |
Median (IQR) | |
Age (yr) | 59 (52-64) |
BMI (kg/m²) | 26 (23.9-29.4) |
Days on the waiting list | 25 (7-92) |
Lab MELD | 16 (11-21) |
BAR | 7 (4-10) |
Table 3 Cox proportional hazards model – all variables and metrics
Variable | Coefficient (95%CI) | Hazard ratio (95%CI) | P value |
Donor pre-procurement cardiac arrest (yes) | 0.400 (0.027, 0.774) | 1.493 (1.028, 2.168) | 0.035 |
Recipient age | 0.031 (0.014, 0.049) | 1.032 (1.014, 1.050) | < 0.001 |
Donor CRP | 0.001 (0.000, 0.003) | 1.001 (0.999, 1.003) | 0.055 |
BAR score | 0.031 (-0.001, 0.064) | 1.032 (0.999, 1.066) | 0.060 |
Indication for LT-cancer (HCC, CCC) | 0.137 (-0.275, 0.548) | 1.146 (0.760, 1.730) | 0.515 |
Indication for LT-hepatitis C virus | 1.029 (0.510, 1.548) | 2.798 (1.665, 4.702) | < 0.001 |
Indication for LT-re-transplantation | 0.593 (0.098, 1.087) | 1.809 (1.103, 2.965) | 0.019 |
Indication for LT-miscellaneous | 0.307 (-0.190, 0.803) | 1.359 (0.827, 2.233) | 0.226 |
Indication for LT-cholestatic disease | -0.371 (-1.168, 0.426) | 0.690 (0.311, 1.532) | 0.362 |
Table 4 Cox proportional hazards model – excluded metrics (Model for End-Stage Liver Disease, Balance of Risk, and Eurotransplant Donor Risk Index score)
Variable | Coefficient (95%CI) | Hazard ratio (95%CI) | P value |
Donor pre-procurement cardiac arrest (yes) | 0.401 (0.029, 0.774) | 1.494 (1.029, 2.168) | 0.035 |
Recipient age | 0.034 (0.016, 0.051) | 1.034 (1.016, 1.053) | < 0.001 |
Donor CRP | 0.001 (0.000, 0.003) | 1.001 (0.999, 1.003) | 0.060 |
Indication for LT-cancer (HCC, CCC) | 0.062 (-0.342, 0.465) | 1.064 (0.711, 1.592) | 0.764 |
indication for LT-hepatitis C virus | 1.033 (0.515, 1.552) | 2.811 (1.673, 4.722) | < 0.001 |
Indication for LT-re-transplantation | 0.806 (0.367, 1.245) | 2.240 (1.444, 3.474) | < 0.001 |
Indication for LT-miscellaneous | 0.353 (-0.140, 0.845) | 1.423 (0.870, 2.328) | 0.160 |
Indication for LT-cholestatic disease | -0.346 (-1.144, 0.451) | 0.707 (0.319, 1.570) | 0.395 |
Table 5 Cox proportional hazards model – all variables; excluded retransplanted patients
Variable | Coefficient (95%CI) | Hazard ratio (95%CI) | P value |
Donor pre-procurement cardiac arrest (yes) | 0.393 (-0.0281, 0.813) | 1.481 (0.972, 2.255) | 0.067 |
Recipient age | 0.001 (-0.039, 0.040) | 1.001 (0.961, 1.041) | 0.98 |
Donor CRP | 0.002 (0.001, 0.004) | 1.002 (1.001, 1.004) | 0.006 |
Lab MELD | 0.027 (-0.034, 0.088) | 1.028 (0.967, 1.092) | 0.380 |
BAR score | 0.024 (-0.056, 0.104) | 1.024 (0.946, 1.109) | 0.557 |
Indication for LT-cancer (HCC, CCC) | -2.867 (-6.365, 0.631) | 0.057 (0.002, 1.878) | 0.108 |
Indication for LT-hepatitis C virus | -4.492 (-9.517, 0.532) | 0.011 (0.000, 1.703) | 0.080 |
Indication for LT-miscellaneous | -0.917 (-4.091, 2.257) | 0.400 (0.017, 9.555) | 0.571 |
indication for LT-cholestatic disease | 0.325 (-3.841, 4.490) | 1.384 (0.021, 9.146) | 0.879 |
Lab MELD × cancer (HCC, CCC) | 0.026 (-0.030, 0.083) | 1.027 (0.970, 1.086) | 0.363 |
Lab MELD × hepatitis C virus | -0.023 (-0.089, 0.044) | 0.978 (0.915, 1.044) | 0.500 |
Lab MELD × indication miscellaneous | -0.034 (-0.091, 0.024) | 0.967 (0.913, 1.024) | 0.253 |
Lab MELD × cholestatic disease | -0.177 (-0.331, -0.024) | 0.838 (0.718, 0.977) | 0.023 |
Recipient age × cancer (HCC, CCC) | 0.047 (-0.009, 0.102) | 1.048 (0.991, 1.107) | 0.098 |
Recipient age × hepatitis C virus | 0.103 (0.021, 0.186) | 1.109 (1.022, 1.204) | 0.013 |
Recipient age × indication miscellaneous | 0.032 (-0.020, 0.083) | 1.033 (0.980, 1.088) | 0.228 |
Recipient age × cholestatic disease | 0.038 (-0.036, 0.112) | 1.039 (0.965, 1.118) | 0.309 |
Table 6 Cox proportional hazards model-excluded metrics (Model for End-Stage Liver Disease, Balance of Risk, and Eurotransplant Donor Risk Index score) and retransplanted patients
Variable | Coefficient (95%CI) | Hazard ratio (95%CI) | P value |
Donor pre-procurement cardiac arrest (yes) | 0.406 (-0.006, 0.817) | 1.500 (0.994, 2.264) | 0.053 |
Recipient age | 0.035 (0.016, 0.055) | 1.035 (1.016, 1.004) | < 0.001 |
Donor CRP | 0.002 (0.000, 0.004) | 1.002 (1.000, 1.004) | 0.015 |
Indication for LT-cancer (HCC, CCC) | 0.064 (-0.341, 0.469) | 1.066 (0.711, 1.599) | 0.757 |
Indication for LT-hepatitis C virus | 1.058 (0.538, 1.578) | 2.881 (1.712, 4.846) | < 0.001 |
Indication for LT-miscellaneous | 0.365 (-0.128, 0.859) | 1.442 (0.880, 2.361) | 0.146 |
Indication for LT-cholestatic disease | -0.328 (-1.126, 0.470) | 0.720 (0.324, 1.600) | 0.420 |
Table 7 Donor characteristics and comparison of the older and younger group
Older (n = 87) | Younger (n = 124) | P value | Test | |
Gender | < 0.01 | χ2 test | ||
Male | 44 (50.57) | 88 (70.97) | ||
Female | 43 (49.43) | 36 (29.03) | ||
Steatosis | 0.4 | χ2 test | ||
Negligible | 70 (81.40) | 96 (78.69) | ||
Mild | 12 (13.95) | 13 (10.66) | ||
Moderate | 4 (4.65) | 12 (9.84) | ||
Severe | 0 (0) | 1 (0.82) | ||
Cardiac arrest | 0.01 | χ2 test | ||
No | 81 (93.1) | 99 (79.8) | ||
Yes | 6 (6.9) | 25 (20.2) | ||
Age | 77 (76-80) | 32 (23-40) | < 0.01 | Mann-Whitney |
BMI (kg/m²) | 27.55 (25.23-29.4) | 24.69 (22.75-26.31) | < 0.01 | Mann-Whitney |
ET-DRI | 2.02 (1.85-2.05) | 1.28 (1.15-1.46) | < 0.01 | Mann-Whitney |
Sodium(mEq/L) | 147 ± 7.6 (133-165) | 146 ± 8.9 (120-169) | 0.51 | t-test |
ALT (U/L) | 33.8 ± 51.3 (5-385) | 93.9 ± 130.3 (8-898) | < 0.01 | t-test |
GGT (U/L) | 48.5 ± 76.1 (4-581) | 90.1 ± 163.1 (6-1129) | 0.03 | t-test |
Bilirubin(mg/dL) | 15.4 ± 10.9 (3-71) | 13.6 ± 16.4 (1-146) | 0.38 | t-test |
CRP (mg/L) | 175.8 ± 104.7 (1-440) | 157.6 ± 94.1 (1-360) | 0.2 | t-test |
CIT (h) | 6.44 ± 2.1 (2.17-11.45) | 7.73 ± 2.7 (1.93-13.87) | < 0.01 | t-test |
Table 8 Recipient characteristics and comparison of the older and younger group
Older (n = 87) | Younger (n = 124) | P value | Test | |
Gender | 0.03 | χ2 test | ||
Male | 70 (80.46) | 82 (66.13) | ||
Female | 17 (19.54) | 42 (33.87) | ||
Indication for LT | 0.4 | χ2 test | ||
Alcoholic cirrhosis | 38 (43.68) | 32 (25.81) | ||
Cancer (HCC, CCC) | 33 (37.94) | 29 (23.39) | ||
Viral hepatitis | 6 (6.9) | 18 (14.52) | ||
Miscellaneous | 10 (11.5) | 45 (36.32) | ||
Urgency | ||||
Elective | 87 (100) | 118 (95.16) | 0.04 | Fischer's exact test |
High | 0 (0) | 6 (4.84) | ||
Stay in ICU | 0.57 | χ2 test | ||
No | 65 (74.71) | 98 (79.03) | ||
Yes | 22 (25.29) | 26 (20.97) | ||
Age | 60 (55-66) | 58 (50-63) | < 0.01 | Mann-Whitney |
BMI (kg/m²) | 27.92 (24.61-29.91) | 25.25 (23.45-27.3) | < 0.01 | Mann-Whitney |
MELD | 15 (11-18) | 16 (11-21) | 0.13 | Mann-Whitney |
BAR | 5 (4-9) | 6 (2-9) | 0.45 | Mann-Whitney |
- Citation: Bezjak M, Stresec I, Kocman B, Jadrijević S, Filipec Kanizaj T, Antonijević M, Dalbelo Bašić B, Mikulić D. Influence of donor age on liver transplantation outcomes: A multivariate analysis and comparative study. World J Gastrointest Surg 2024; 16(2): 331-344
- URL: https://www.wjgnet.com/1948-9366/full/v16/i2/331.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v16.i2.331