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Multi-factor analysis of initial poor graft function after orthotopic liver transplantation |
Hao Chen, Cheng-Hong Peng, Bai-Yong Shen, Xia-Xing Deng, Chuan Shen, Jun-Jie Xie, Wei Dong and Hong-Wei Li |
Shanghai, China
Author Affiliations: Center of Organ Transplantation, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China (Chen H, Peng CH, Shen BY, Deng XX, Shen C, Xie JJ, Dong W and Li HW)
Corresponding Author: Hao Chen, MD, PhD, Center of Organ Transplantation, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China (Tel: 86-21-64370045ext666710; Fax: 86-21-64333548; Email: haochendr@yahoo.com.cn) |
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Abstract BACKGROUND: In the early period of orthotopic liver transplantation (OLT), initial poor graft function (IPGF) is one of the complications which leads to primary graft non-function (PGNF) in serious cases. This study set out to establish the clinical risk factors resulting in IPGF after OLT.
METHODS: Eighty cases of OLT were analyzed. The IPGF group consisted of patients with alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) above 1500 IU/L within 72 hours after OLT, while those in the non-IPGF group had values below 1500 IU/L. Recipient-associated factors before OLT analyzed were age, sex, primary liver disease and Child-Pugh classification; factors analyzed within the peri-operative period were non-heart beating time (NHBT), cold ischemia time (CIT), rewarming ischemic time (RWIT), liver biopsy at the end of cold ischemia; and factors analyzed within 72 hours after OLT were ALT and/or AST values. A logistic regression model was applied to filter the possible factors resulting in IPGF.
RESULTS: Donor NHBT, CIT and RWIT were significantly longer in the IPGF group than in the non-IPGF group; in the logistic regression model, NHBT was the risk factor leading to IPGF (P<0.05), while CIT and RWIT were possible risk factors. In one case in the IPGF group, PGNF appeared with moderate hepatic steatosis.
CONCLUSIONS: Longer NHBT is an important risk factor leading to IPGF, while serious steatosis in the donor liver, CIT and RWIT are potential risk factors.
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