Donor Factors Including Donor Risk Index Predict Fibrosis Progression, Allograft Loss, and Patient Survival following Liver Transplantation for Hepatitis C Virus

Arun Jesudian, Sameer Desale, Jonathan Julia, Elizabeth Landry, Christopher Maxwell, Bhaskar Kallakury, Jacqueline Laurin, Kirti Shetty

Research output: Contribution to journalArticlepeer-review

Abstract

Background The utilization of liver transplantation (LT) is limited by the availability of suitable organs. This study aimed to assess the impact of the donor risk index (DRI) and other donor characteristics on fibrosis progression, graft, and patient survival in hepatitis C virus (HCV)-infected LT recipients. Methods HCV-infected LT recipients who had at least 2 post-LT protocol liver biopsy specimens available were included. Hazard ratio for bivariate analysis was computed using Cox proportional hazard regression analysis. Results Of 312 recipients, 26.6% died over a median follow-up of 58.5 months (95% CI: 46.5–67.3). Fourteen patients underwent re-transplantation. Mean time to graft failure was 84.3 months, median follow-up: 59 months, 95% CI (48.2, 68.3). DRI >1.5 was significantly associated with patient and graft survival (P = 0.04). Of the subset of 104 individuals who underwent histological analysis, 67.3% progressed to ≥F2. On multivariate analysis, significant donor-specific predictors of fibrosis progression were: donor age >50 years and DRI >1.7. Conclusions (1) Fibrosis progression in HCV-infected LT recipients is strongly associated with donor characteristics, specifically donor age and DRI. (2) DRI, an objective measure of donor quality, appears to correlate both with rate of histological progression and overall patient/graft survival.

Original languageEnglish (US)
Pages (from-to)109-114
Number of pages6
JournalJournal of Clinical and Experimental Hepatology
Volume6
Issue number2
DOIs
StatePublished - Jun 1 2016

Keywords

  • Hepatitis C
  • donor risk index
  • liver transplantation

ASJC Scopus subject areas

  • Hepatology

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