Affiliation:
1. Department of Infectious, Parasitic and Immunomediated Diseases (FQ, OP) and Italian National Transplant Center (DAM, SV, ANC), Istituto Superiore di Sanità, Rome, Italy; Molecular Epidemiology and Genetics Unit, Ospedale Policlinico, Milan, Italy (ET)
Abstract
Objective To analyze the graft outcome after liver transplantation in Italy in the years 1995 to 2000. Methods We performed a longitudinal study with follow-up at 3 months, 1 year, 3 years, and 5 years on 1987 liver grafts. The effect of several variables on graft survival was also analyzed. Results Several variables affect graft survival: Donor and recipient older age, gender mismatching, prolonged cold ischemia time, acute hepatic necrosis, and retransplantation are reported to significantly affect liver graft survival. Donors older than 60 years show a relative risk of 1.59 (95% CI, 1.23–2.05) compared with donors with an age between 19 and 60 years; recipients older than 50 years show a relative risk of 1.29 (95% CI, 1.04–1.60) compared with recipients aged 19 to 50 years. A cold ischemia time of 12 hours or longer doubled the risk of failure (relative risk = 2.01, 95% CI, 1.36–2.96) compared with a cold ischemia time of less than 6 hours. Conclusions The results show that the overall quality of liver transplantation in Italy is satisfying and comparable to the outcome reported by international registries. Follow-up studies on large numbers of liver transplants are useful to define predictors of outcome, and subsequently modify the criteria for organ allocation.