Donor Influence on Outcome in Patients Undergoing Liver Transplant for Primary Biliary Cirrhosis

Abstract

Objectives: Risk factors for survival after liver transplant owing to primary biliary cirrhosis have been extensively investigated, whereas the donor-specific influence and particularly, the histologic data, has not been sufficiently analyzed.

Patients and Methods: Donor data of 121 patients who underwent liver transplant for primary biliary cirrhosis and histologic findings of 69 donor liver grafts were assessed according to preoperative status and histologic criteria. Findings were correlated with the histologic and clinical course up to 20 years after orthotopic liver transplant.

Results: Risk factors for death were a longer stay in intensive care units (> 7 days) (P < .02), a hypotensive period > 60 minutes (P < .03), and the administration of red blood cells (P < .04). Grafts from donors with liver fibrosis (P < .03), fatty degeneration (P < .04), and liver cell hydrops (P < .04) resulted in a significantly higher risk of primary biliary cirrhosis recurrence. Log rank analysis revealed a significant decreased survival for patients if donors had a prolonged hypotensive period (P < .02) and administration of epinephrine (P < .03) and red blood cells (P < .05).

Conclusions: Our results show that donor histology can affect disease recurrence, especially the grade of inflammation, fibrosis, and fatty degeneration. In addition, prolonged intensive care hospitalization for donors should be avoided.