Department of Transplant Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Am J Transplant. 2012 Oct;12(10):2789-96. doi: 10.1111/j.1600-6143.2012.04195.x. Epub 2012 Jul 23.
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 Kaplan-Meier 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.
最近，我们验证了 Feng 等人提出的供体风险指数 (DRI) 在 Eurotransplant 区域的适用性。虽然该评分系统是评估供体肝质量的有效工具，但对于分配目的而言，为 Eurotransplant 区域量身定制的评分系统可能更为合适。本研究的目的是调查各种供体和移植风险因素，并为 Eurotransplant 区域设计一个风险模型。这是一项对 2003 年 1 月 1 日至 2007 年 12 月 31 日期间 Eurotransplant 中 5939 例来自已故供体的成人受体肝移植的数据库分析。数据采用 Kaplan-Meier 和 Cox 回归模型进行分析。在 5723 例患者中，有 5723 例患者可获得随访数据，平均随访时间为 2.5 年。经过多变量分析，DRI（p < 0.0001）、最新实验室 GGT（p = 0.005）和抢救性分配（p = 0.007）仍然具有统计学意义。这些因素被用于创建 Eurotransplant 供体风险指数 (ET-DRI)。一致性指数计算表明，该 ET-DRI 对肝移植后结局具有较高的预测价值。因此，我们建议在 Eurotransplant 区域内使用该 ET-DRI 进行风险指示，并且可能用于分配目的。
