Primary dysfunction after liver transplantation. Is it possible to predict this complication?
OBJECTIVE
the aim of this study was to evaluate potential risk factors related to the development of primary liver graft dysfunction (PDF), including initial poor function (IPF) and primary nonfunction (PNF), and to describe a statistical predictive model for this complication.


METHODS
to evaluate potential risk factors for the development of PDF (IPF and PNF), patients were classified into three groups on the basis of early postoperative graft function, and their medical charts were reviewed for donor, recipient and peroperative information. To evaluate the prognostic influence of potential risk factors, those that were statistically significant in the univariate analysis were subsequently studied by multivariate analysis using a Cox model. The study group comprised 214 liver transplants performed in 177 recipients.


RESULTS
of the 214 liver transplants considered, 153 (71.5%) presented immediate graft function and 61 (28.5%) developed primary dysfunction. Initial poor function occurred in 43 (20.1%), while in 18 (8.4%) primary nonfunction of the liver was found. The severity of steatosis and preservation injury, recipient serum creatinine level, UNOS status, use of venovenous bypass, intraoperative coagulopathy and intraoperative bile output, reached statistical significance in the multivariate analysis and were predictors of PDF.


CONCLUSIONS
the predictive model obtained is a useful tool to evaluate donors and recipients for liver transplantation, and for the early detection of primary dysfunction.
Moreno Sanz
C
C
Servicio de Cirugía General, Aparato Digestivo y Transplante de Organos Abdominales, Hospital "12 de Octubre", Madrid, España.
Jiménez Romero
C
C
Moreno González
E
E
García García
I
I
Seoane González
I
I
Loinaz Segurola
C
C
García Ureña
M A
MA
González Chamorro
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D008099:Liver / Q000503:physiopathology*; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods / Q000502:physiology* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology*; D011300:Preoperative Care / Q000706:statistics & numerical data; D011379:Prognosis; D012307:Risk Factors; D014019:Tissue Donors / Q000706:statistics & numerical data