Multi-factor analysis of initial poor graft function after orthotopic liver transplantation.
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.
Chen
Hao
H
Center of Organ Transplantation, Ruijin Hospital, Shanghai Second Medical University, Shanghai, China. haochendr@yahoo.com.cn
Peng
Cheng-Hong
CH
Shen
Bai-Yong
BY
Deng
Xia-Xing
XX
Shen
Chuan
C
Xie
Jun-Jie
JJ
Dong
Wei
W
Li
Hong-Wei
HW
D000328:Adult; D000368:Aged; D050377:Cold Ischemia; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014184:Transplantation, Homologous