title: Preservation injury in clinical liver transplantation: incidence and effect on rejection and survival.
abstract: The distribution of the severity of preservation injury (PI), its association with acute early rejection, and its effect on graft and patient survival were examined in 151 patients transplanted between 9/88 and 12/91. PI was graded into mild, moderate and severe using prothrombin time (PT) on the 2nd POD and peak AST and ALT levels of the first 3 days after transplant. Of the 151 patients, 104 (68.8%) had minimal, 24 (15.9%) had moderate, and 23 (15.3%) had severe PI. The rate of early rejection, within 21 days after transplant, (54.8% vs 54.2% vs 52.2%) and its timing (10.0 +/- 0.5 vs 8.8 +/- 0.8 vs 8.9 +/- 1.4 days) as well as the incidence of steroid-resistant rejection (21.4% vs 33% vs 30%) did not differ significantly among groups. Graft survival was significantly lower in the severe PI group than among patients with minimal PI at 3 months and 24 months (65.2% vs 86.2%; p < 0.05 and 58.3% vs 82.7%; p < 0.05, respectively). Patient survival at 3 and 24 months was similar among the groups (91.1% vs. 95.8% vs 86.9% and 81.9% vs 91.1% vs. 74.3%). We conclude that the cellular damage associated with preservation injury does not predispose to development of acute rejection.
authors: Department of Surgery, Mount Sinai Medical Center, New York, New York.
authors: E
authors: E
authors: Katz
authors: E
authors: E
authors: Mor
authors: M E
authors: ME
authors: Schwartz
authors: N
authors: N
authors: Theise
authors: T
authors: T
authors: Patel
authors: C M
authors: CM
authors: Miller
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D006084:Graft Rejection / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D016031:Liver Transplantation / Q000401:mortality; D009926:Organ Preservation / Q000009:adverse effects*; D015427:Reperfusion Injury / Q000473:pathology; D012189:Retrospective Studies
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase