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©The Author(s) 2023.
World J Hepatol. Feb 27, 2023; 15(2): 255-264
Published online Feb 27, 2023. doi: 10.4254/wjh.v15.i2.255
Published online Feb 27, 2023. doi: 10.4254/wjh.v15.i2.255
Table 1 Descriptive analysis of donor organ characteristics per year, n (%)
| Variable (year) | 2017 | 2018 | 2019 | 2020 | Total |
| Donor's place of origin | |||||
| Local | 121 (48.21%) | 180 (38.88%) | 261 (57.36%) | 257 (57.11%) | 819 (50.59%) |
| Regional | 67 (26.69%) | 149 (32.18%) | 128 (28.13%) | 131 (29.11%) | 475 (29.34%) |
| Nacional | 63 (25.10%) | 134 (28.94%) | 66 (14.51%) | 62 (13.78%) | 325 (20.07%) |
| Gender, female | 119 (47.60%) | 193 (41.87%) | 190 (41.76%) | 174 (38.75%) | 676 (41.86%) |
| Blood type (ABO system) | |||||
| A | 82 (32.93%) | 150 (32.47%) | 157 (34.58%) | 168 (37.42%) | 557 (34.51%) |
| B | 38 (15.26%) | 52 (11.26%) | 48 (10.57%) | 36 (8.02%) | 174 (10.78%) |
| AB | 11 (4.42%) | 16 (3.46%) | 25 (5.51%) | 7 (1.56%) | 59 (3.66%) |
| O | 118 (47.39%) | 244 (52.81%) | 224 (49.34%) | 238 (53.01%) | 824 (51.05%) |
| Race | |||||
| Black | 39 (15.54%) | 42 (9.07%) | 57 (12.53%) | 46 (10.22%) | 184 (11.37%) |
| Mixed-race | 80 (31.87%) | 164 (35.42%) | 159 (34.95%) | 178 (39.56%) | 581 (35.89%) |
| White | 123 (49.00%) | 253 (54.64%) | 235 (51.65%) | 223 (49.56%) | 834 (51.51%) |
| Others | 9 (3.59%) | 4 (0.86%) | 4 (0.88%) | 3 (0.67%) | 20 (1.24%) |
| Age (categories) | |||||
| < 40 yr | 48 (19.12%) | 90 (19.44%) | 104 (22.86%) | 115 (25.56%) | 357 (22.05%) |
| 40 yr to 49 yr | 58 (23.11%) | 102 (22.03%) | 91 (20.00%) | 106 (23.56%) | 357 (22.05%) |
| 50 yr to 59 yr | 77 (30.68%) | 134 (28.94%) | 136 (29.89%) | 123 (27.33%) | 470 (29.03%) |
| 60 yr to 69 yr | 53 (21.12%) | 99 (21.38%) | 105 (23.08%) | 82 (18.22%) | 339 (20.94%) |
| ≥ 70 yr | 15 (5.98%) | 38 (8.21%) | 19 (4.18%) | 24 (5.33%) | 96 (5.93%) |
| Age (yr) | 50.50 (14.52) | 50.77 (15.07) | 50.00 (14.09) | 47.85 (15.03) | 49.70 (14.74) |
| ICU stay > 5 d | 105 (41.83%) | 187 (40.39%) | 178 (39.12%) | 200 (44.44%) | 670 (41.38%) |
| Cause of death | |||||
| Cerebrovascular accident | 175 (70.00%) | 294 (63.50%) | 298 (65.49%) | 277 (61.56%) | 1044 (64.52%) |
| Trauma | 43 (17.20%) | 113 (24.41%) | 101 (22.20%) | 121 (26.89%) | 378 (23.36%) |
| Hypoxia | 24 (9.60%) | 45 (9.72%) | 40 (8.79%) | 41 (9.11%) | 150 (9.27%) |
| Others | 8 (3.20%) | 11 (2.38%) | 16 (3.52%) | 11 (2.44%) | 46 (2.84%) |
| BMI (kg/m2) | 27.28 (5.04) | 26.65 (5.00) | 26.69 (4.57) | 26.31 (4.20) | 26.66 (4.68) |
| Alcoholism | 75 (29.88%) | 148 (31.97%) | 115 (25.27%) | 103 (22.89%) | 441 (27.24%) |
| Cardiorespiratory arrest | 61 (24.30%) | 99 (21.38%) | 82 (18.02%) | 77 (17.11%) | 319 (19.70%) |
| Vasoactive drugs in the donor | 221 (88.05%) | 422 (91.14%) | 408 (89.67%) | 405 (90.00%) | 1456 (89.93%) |
| AST (U/L)1 | 56.00 (32.00; 102.00) | 64.50 (37.00; 125.00) | 74.00 (39.00; 151.00) | 74.00 (39.40; 141.00) | 68.00 (38.00; 132.00) |
| ALT (U/L)1 | 47.00 (24.00; 93.00) | 49.00 (29.00; 96.00) | 45.70 (26.00; 103.00) | 47.00 (28.00; 89.00) | 47.00 (27.00; 96.00) |
| GGT (U/L)1 | 84.00 (34.00; 182.00) | 94.50 (38.55; 200.00) | 83.50 (39.00; 207.00) | 84.00 (36.00; 197.50) | 87.00 (37.00; 198.00) |
| Total bilirubin (mg/dL)1 | 0.50 (0.32; 0.91) | 0.50 (0.30; 0.91) | 0.55 (0.35; 0.97) | 0.52 (0.35; 0.90) | 0.52 (0.33; 0.92) |
Table 2 Descriptive analysis of donor extended criteria over the years, n (%)
| Variable (year) | 2017 | 2018 | 2019 | 2020 | Total |
| Macroscopic assessment of steatosis in the organ | 5 (1.99) | 0 (0.00) | 3 (0.66) | 4 (0.89) | 12 (0.74) |
| Age > 65 yr | 35 (14.00) | 69 (14.90) | 67 (14.73) | 52 (11.56) | 223 (13.78) |
| ICU > 7 d | 81 (32.27) | 143 (30.89) | 145 (31.87) | 153 (34.00) | 522 (32.24) |
| BMI > 30 kg/m2 | 61 (24.30) | 82 (17.71) | 90 (19.78) | 80 (17.78) | 313 (19.33) |
| Serum sodium > 165 mmol/L | 39 (15.54) | 82 (17.71) | 73 (16.04) | 64 (14.22) | 258 (15.94) |
| AST > 90 U/L | 72 (28.69) | 172 (37.23) | 184 (40.44) | 187 (41.65) | 615 (38.03) |
| ALT > 105 U/L | 54 (21.51) | 108 (23.38) | 111 (24.45) | 93 (20.71) | 366 (22.65) |
| Total bilirubin > 3 mg/dL | 6 (2.39) | 13 (2.83) | 25 (5.51) | 18 (4.01) | 62 (3.84) |
| Number of variables to classify a donor as an extended criteria donor | |||||
| 0 | 54 (21.51) | 96 (20.73) | 106 (23.30) | 95 (21.11) | 351 (21.68) |
| 1 | 94 (37.45) | 159 (34.34) | 122 (26.81) | 158 (35.11) | 533 (32.92) |
| 2 | 61 (24.30) | 133 (28.73) | 133 (29.23) | 119 (26.44) | 446 (27.55) |
| 3 | 32 (12.75) | 58 (12.53) | 68 (14.95) | 59 (13.11) | 217 (13.40) |
| 4 | 9 (3.59) | 15 (3.24) | 24 (5.27) | 17 (3.78) | 65 (4.01) |
| 5 | 1 (0.40) | 2 (0.43) | 2 (0.44) | 2 (0.44) | 7 (0.43) |
Table 3 Occurrence of donor extended criteria according to the year of offer
| Variable | Odds ratio (95%CI) | P value |
| Absence of macroscopic steatosis in the donor organ | 0.845 (0.491; 1.455) | 0.545 |
| Donor age > 65 yr | 0.925 (0.808; 1.059) | 0.259 |
| ICU stay > 7 d | 1.037 (0.938; 1.147) | 0.473 |
| BMI > 30 kg/m2 | 0.915 (0.813; 1.030) | 0.140 |
| Serum sodium > 165 mmol/L | 0.943 (0.830; 1.071) | 0.364 |
| AST > 90 U/L | 1.177 (1.068; 1.298) | 0.001 |
| ALT > 105 U/L | 0.979 (0.876; 1.095) | 0.717 |
| Total bilirubin > 3 mg/dL | 1.223 (0.952; 1.572) | 0.116 |
| ≥ 1 donor extended criteria | 0.991 (0.885; 1.110) | 0.878 |
Table 4 Analysis of the relationship between the occurrence of donor extended criteria and the refusal rate of liver allografts for transplantation
| Logistic regression for donor organ refusal for transplantation (n = 1619) | ||
| Variable | Odds ratio for refusal (95%CI) | P value |
| Absence of macroscopic steatosis in the donor organ | 0.072 (0.016; 0.332) | < 0.001 |
| Donor age > 65 yr | 1.814 (1.264; 2.603) | 0.001 |
| ICU stay > 7 d | 1.810 (1.408; 2.328) | < 0.001 |
| BMI > 30 kg/m2 | 2.215 (1.601; 3.065) | < 0.001 |
| Serum sodium > 165 mmol/L | 1.173 (0.862; 1.596) | 0.310 |
| AST > 90 U/L | 1.713 (1.352; 2.171) | < 0.001 |
| ALT > 105 U/L | 2.007 (1.493; 2.697) | < 0.001 |
| Total bilirubin > 3 mg/dL | 3.011 (1.361; 6.664) | 0.007 |
Table 5 Analysis of the relationship between the occurrence of donor extended criteria and the refusal rate of liver allografts for transplantation
| Multiple logistic regression model for donor organ refusal for transplantation (n = 1619) | |||
| Variable | Estimated proportionof refusal (95%CI) | Odds ratio for refusal (95%CI) | P value |
| Absence of macroscopic steatosis in the donor organ | 41.10% (12.04%; 78.06%) | 0.064 (0.013; 0.307) | < 0.001 |
| Donor age > 65 yr | 79.54% (59.84%; 91.02%) | 1.973 (1.360; 2.861) | < 0.001 |
| ICU stay > 7 d | 79.18% (60.23%; 90.52%) | 1.888 (1.455; 2.450) | < 0.001 |
| BMI > 30 kg/m2 | 80.69% (62.19%; 91.39%) | 2.279 (1.628; 3.190) | < 0.001 |
| AST > 90 U/L | 76.57% (56.61%; 89.11%) | 1.394 (1.051; 1.848) | 0.021 |
| ALT > 105 U/L | 78.44% (58.88%; 90.24%) | 1.729 (1.217; 2.456) | 0.002 |
| Total bilirubin > 3 mg/dL | 82.44% (60.00%; 93.63%) | 2.877 (1.282; 6.454) | 0.010 |
- Citation: Braga VS, Boteon APCS, Paglione HB, Pecora RAA, Boteon YL. Extended criteria brain-dead organ donors: Prevalence and impact on the utilisation of livers for transplantation in Brazil. World J Hepatol 2023; 15(2): 255-264
- URL: https://www.wjgnet.com/1948-5182/full/v15/i2/255.htm
- DOI: https://dx.doi.org/10.4254/wjh.v15.i2.255