1. DONOR RISK INDEX-LIVER GRAFT SURVIVAL ASSOCIATION IN PATIENTS OVER 18 YEARS OF AGE IN ARGENTINA Bisigniano Liliana MD., López-Rivera Arturo MD., Tagliafichi Viviana, Fernández Víctor J MD., Soratti Carlos A MD.

2. Introduction Due to the larger number of patients waiting for a liver transplant, the limits for the use of organs available have been expanded worldwide. The donor risk index (DRI) uses donor variables proven to be associated with graft survival in liver transplantation in patients over 18.

3. Introduction An analysis must be conducted to define the potential effect of certain features of the donor on graft survival. The Risk Index in Cadaveric Donors (RICD) was designed based on this idea.

4. Objective  To assess, by means of an adequate statistical analysis, whether the RICD is an independent predictor of liver graft survival  To analyze the association between the donor risk index score and graft survival en liver transplantation in patients over 18 years of age in Argentina.

5. Materials & Methods The information was obtained from the SINTRA for the period July 2005 to December 2010 Multiorgan transplants were excluded The statistical packages used were MedCal version 10.3.2.0 and SPSS version 17.

6. Materials & Methods We estimated the graft survival at 30 days, 1 and 5 years using the nonparametric Kaplan- Meier method. By using the Cox regression model, the relationship of the DRI with graft survival adjusted for the following variables of the recipient was studied: INDEPENDET VARIABLES Age BMI (>18.5, 30) Etiology of liver failure Blood type compatibility

7. Materials & Methods Graft survival at 30 days, 1 and 5 years using the nonparametric Kaplan-Meier method. By using the Cox regression model:relationship of the DRI with graft survival adjusted for the following variables of the recipient: BMI (>18.5, 30), etiology of liver failure, blood type compatibility The clinical condition was not used (only 4 patients in emergency.

8. Materials & Methods DONOR RISK INDEX AGE<40-<50<50-<60<60-<70>70 CAUSE OF DEATHANOXIASTROKE≠ HEAD TRAUMA RACEBLACK≠ Caucasian CARDIAC ARRESTYesNo SPLITYesNo ALLOCATIONNationalRegional CIT< 8hours> 8hours DRI values were coded into 6 categories No values between 0 and 1.2 11.2-1.4 21.4-1.5 31.5-1.6 41.6-1.8 51.8-2.0 6>2.0

9. Results RECIPIENT MEAN AGE51.04+ 12.72 YEARS GRAFTER 30 days 86.1%0.0108 1 year 77.4%0.0138 5 years 58.1%0.297 1116 transplant procedures were performed

10. Results 30 days1 year5 years 86.1%77.4%58.1%

11. Results HRCI 95%p Category 21.040.63-1.720.883 Category 31.100.64-1.890.98 Category 40.980.57-1.700.984 Category 50.990.57-1.700.984 Category 60.860.50-1.460.563 We evaluated the association of each of the categories of DRI with graft survival adjusted according to the rest of the variables by using the Cox regression model. All the categories were compared vs category 1

12. Conclusions The scores of the DRI have no association with graft survival in liver transplantation in patients over 18 years of age in the Argentine population. Studies to design a DRI with data from the Argentine donors should be performed.