The Eurotransplant Donor Risk Index in Liver Transplantation: ET-DRI
The Eurotransplant Donor Risk Index in Liver Transplantation: ET-DRI
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DOI：
10.1111/j.1600-6143.2012.04195.x
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发表时间：
2012-10-01
影响因子：
8.8
通讯作者：
Ringers, J.
中科院分区：
文献类型：
--
作者：
Braat, A. E.;Blok, J. J.;Ringers, J.
最近，我们验证了Feng等人在欧洲移植地区进行的供体风险指数（DRI）。尽管该评分系统是对供体肝脏质量进行评分的有效工具，但出于分配目的，为欧洲移植区域定制的评分系统可能更合适。我们的研究目的是调查各种供体和移植的风险因素，并设计一个风险模型的欧洲移植区域。这项研究是对2003年1月1日至2007年12月31日在欧洲移植中心进行的所有5939例死亡供体向成年受体进行肝移植的数据库分析。采用KaplanMeier和考克斯回归模型对数据进行分析。从5723例患者中获得了平均2.5年的随访数据。多变量分析后，DRI（p < 0.0001）、最新实验室GGT（p = 0.005）和补救分配（p = 0.007）仍具有显著性。这些因素被用来创建欧洲移植供体风险指数（ET-DRI）。一致性指数计算表明，该ET-DRI对肝移植术后结局具有较高的预测价值。因此，我们建议将该ET-DRI用于风险指示，并可能用于欧洲电厂区域内的分配目的。
Recently we validated the donor risk index (DRI) as conducted by Feng et al. for the Eurotransplant region. Although this scoring system is a valid tool for scoring donor liver quality, for allocation purposes a scoring system tailored for the Eurotransplant region may be more appropriate. Objective of our study was to investigate various donor and transplant risk factors and design a risk model for the Eurotransplant region. This study is a database analysis of all 5939 liver transplantations from deceased donors into adult recipients from the 1st of January 2003 until the 31st of December 2007 in Eurotransplant. Data were analyzed with KaplanMeier and Cox regression models. From 5723 patients follow-up data were available with a mean of 2.5 years. After multivariate analysis the DRI (p < 0.0001), latest lab GGT (p = 0.005) and rescue allocation (p = 0.007) remained significant. These factors were used to create the Eurotransplant Donor Risk Index (ET-DRI). Concordance-index calculation shows this ET-DRI to have high predictive value for outcome after liver transplantation. Therefore, we advise the use of this ET-DRI for risk indication and possibly for allocation purposes within the Eurotrans-plant region.