Early graft dysfunction and mortality rate in marginal donor liver transplantation

Background/aim: To determine the effect of marginal donor livers on mortality and graft survival in liver transplantation (LT) recipients. Materials and methods: Donors with any 1 of following were considered marginal donors: age ≥65 years, sodium level ≥165 mmol/L and cold ischemia time ≥12 h. Donors were classified according to the donor risk index (DRI) 1.7 and ≥1.7. The transplant recipients’ model for end-stage liver disease (MELD) scores were considered low if 20 and high if ≥20. Early graft dysfunction (EGD) and mortality rate were evaluated. Results: During the study period 47 patients underwent cadaveric LT. The mean age of the donors and recipients was 45 years (range: 5¬–72 years) and 46 years (range: 4–66 years), respectively. In all, there were 15 marginal donors and 18 donors with a DRI 1.7. In total, 4 LT patients that received livers from marginal donors and 5 that received livers from donors with a DRI ≥1.7 had EGD. Among the recipients of marginal livers, 5 died, versus 4 of the recipients of standard livers. There was no significant difference in EGD or mortality rate between the patients that received livers from marginal donors or those with a DRI ≥1.7 and patients that received standard donor livers. Conclusion: Marginal and DRI ≥1.7 donors negatively affected LT outcomes, but not significantly.