Table 4.
Parameters | Total WIT | UC-DCD | UK-DCD-Risk-Score (5) | UCLA-DCD | KCH-DCD |
---|---|---|---|---|---|
index | score | score (3) | Risk-Index (4) | ||
Donor variables | |||||
Donor age, years | - | <30 y: 0 | ≤60 y: 0 | - | - |
30–60 y: 6 | >60 y: 2 | ||||
≥60 y: 9 | |||||
Donor BMI, kg/m2 | - | - | ≤25 kg/m2: 0 | - | - |
>25 kg/m2: 3 | |||||
Donor HBV core antibody positivity | - | - | - | No: 0 | - |
Yes: 1 | - | ||||
Donor WIT, minutes | ≤20 min: 0 | <25 min: 0 | ≤20 min: 0 | ≤20 min: 0 | ≤25 min: 0 |
>20–30 min: 2 | ≥25 min: 5 | >20 min to | >20 min: 1 | >25 min: 1 | |
≤30 min: 3 | |||||
>30 min: 4 | >30 min: 6 | ||||
Donor hepatectomy time, minutes | <40 min: 0 | <70 min: 0 | - | - | <40 min: 0 |
40–60 min: 1 | ≥70 min: 6 | 40–60 min: 1 | |||
>60 min: 3 | >60 min: 4 | ||||
Cold ischemia time, hours | - | <7 h: 0 | ≤6h: 0 | ≤6h: 0 | ≤10 h: 0 |
7–10 h: 7 | >6h: 2 | >6h: 1 | >10 h: 1 | ||
≥10 h: 9 | |||||
Recipient variables | |||||
Recipient age, years | <60y: 0 | ≤60y: 0 | - | - | |
≥60y: 6 | >60y: 2 | ||||
Recipient lab MELD, points | - | <24 pts: 0 | ≤25 pts: 0 | - | ≤25 pts: 0 |
24–35 pts: 7 | >25 pts: 2 | >25 pts: 3 | |||
≥35 pts: 10 | |||||
Recipient BMI, kg/m2 | - | <40 kg/m2: 0 | ≤30: 0 | ||
≥40 kg/m2: 6 | >30: 1 | - | |||
Recipient underlying disease (Primary Indication for Transplant) | - | *Low risk: 0 | - | HCV with | **Low risk: 0 |
0 | Malignancy: 3 | Standard | |||
High risk: 7 | Non-HCV with | risk: 2 | |||
HCV-HBV: | Malignancy: 2 | High risk: 3 | |||
29 | HCV only: 2 | ||||
Other: 0 | |||||
Recipient retransplantation | - | - | No: 0 | No: 0 | No: 0 |
Yes: 9 | Yes: 2 | Yes: 2 | |||
TIPS | - | No: 0 | - | - | - |
Yes: 7 | |||||
Life support | - | No: 0 | - | - | - |
Yes: 11 |
BMI, body mass index; DCD, donation after cardiac death; MELD, model for end-stage liver disease; HBV, hepatitis B virus; HCV, hepatitis C virus; WIT, warm ischemia time, TIPS, transjugular intrahepatic portosystemic shunt;
Low risk recipient underlying disease: Alpha-1 antitrypsin deficiency, autoimmune hepatitis, Budd-Chiari syndrome, cystic fibrosis, cryptogenic, alcoholic cirrhosis, hepatitis B, hepatocellular carcinoma, hepatitis C, nonalcoholic steato-hepatitis, primary biliary cholangitis, polycystic kidney and liver disease, primary sclerosing cholangitis, Wilson disease; High risk recipient underlying disease: acute liver failure, biliary atresia, hemochromatosis, tumor other than hepatocellular carcinoma, other biliary cirrhosis, other causes; HCV-HBV: combination of hepatitis C and hepatitis B.
Low risk indications for transplant: autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cirrhosis, non-alcoholic steatohepatitis, Hepatitis B virus and cholestatic liver disease (primary familial intrahepatic cholestasis, extrahepatic biliary atresia and Crigler Najjar). Standard risk indications: metabolic diseases that included Wilson's, Hemochromatosis and Familial Amyloid Polyneuropathy. High risk indications: alcohol related liver disease; HCV: Hepatitis C virus, cryptogenic and Budd Chiari. Ref: (4).