Survival rates after liver transplantation using hypertensive donor grafts: an analysis of the Scientific Registry of Transplant Recipients database.

BACKGROUND: The use of grafts from donors with hypertension (HTN) in liver transplantation has grown rapidly recently, but whether HTN donors affect post-liver transplantation survival is unclear.

METHODS: We used data from the Scientific Registry of Transplant Recipients database (2004-2008), and evaluated differences in baseline characteristics and outcomes between recipients of grafts from HTN and non-HTN donors. Kaplan-Meier and multivariate Cox regression models were used in assessing patient survival.

RESULTS: We identified 8,411 recipients of HTN donor grafts (33.2%) and 16,891 (66.8%) recipients of non-HTN donor grafts. Graft and patient survival rates were significantly lower in recipients of HTN donor grafts versus non-HTN donor grafts (1-year, 3-year, and 5-year graft survival rates of 75%, 64%, 50% vs. 80%, 72%, 62% [P < 0.001], respectively, and patient survival rates of 79%, 69%, 56% vs. 83%, 75%, 65% [P < 0.001], respectively). A history of HTN >5 years was also associated with lower rates of graft and patient survival (P < 0.001). A HTN donor was independently associated with a higher risk of graft loss (hazard ratio 1.10, 95% confidence interval 1.01-1.18).

CONCLUSION: The present study shows that graft and patient survivals were lower in recipients of hypertensive donor grafts, and highlights the importance of appropriately screening donors for HTN.