title: Recipient and perioperative risk factors associated with liver transplant graft outcomes.
abstract: BACKGROUND
  Orthotopic liver transplantation (OLT) is currently considered to be the ultimate form of therapy for most patients with end-stage liver diseases. The identification of recipient and various perioperative factors that may affect the graft outcomes is critical. This study sought to analyze the preoperative and perioperative factors associated with graft outcomes in our institute.
  
  
  METHODS
  This retrospective study of liver transplanted patients from January 2002 to December 2009 determined the incidence of 2 forms of primary dysfunction (PDF): Primary nonfunction (PNF) and initial poor function (IPF).
  
  
  RESULTS
  The 97 posttransplant patients included in the study had an average age of 52.74 years. The majority of indications for OLT were hepatitis B and/or C cirrhosis, alcoholic cirrhosis, and hepatocellular carcinoma. The incidence of PDF was 31.9% (31/97) with 7.2% (7/97) PNF and 24.7% (24/97) IPF. Additionally, we observed 68.1% (66/97) to display immediate function (IF). Warm ischemic time (WIT) and operative time were significantly longer in the PDF compared with the IF group. The logistic regression model showed a WIT of >45 minutes to be a risk factor leading to PDF (odds ratio, 11.74; P<.05). An operative time of >6 hours and operative blood loss of >2 L were possible risk factors.
  
  
  CONCLUSIONS
  Prolonged WIT (>45 minutes) was the only significant risk factor among other established parameters for graft function. Nevertheless, reduced operative times and blood loss may improve the outcomes of OLT.
authors.affiliation: Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Y
authors.initials: Y
authors.lastname: Sirivatanauksorn
authors.forename: V
authors.initials: V
authors.lastname: Taweerutchana
authors.forename: S
authors.initials: S
authors.lastname: Limsrichamrern
authors.forename: P
authors.initials: P
authors.lastname: Kositamongkol
authors.forename: P
authors.initials: P
authors.lastname: Mahawithitwong
authors.forename: S
authors.initials: S
authors.lastname: Asavakarn
authors.forename: C
authors.initials: C
authors.lastname: Tovikkai
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D055031:Primary Graft Dysfunction / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013785:Thailand; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome; D052096:Warm Ischemia / Q000009:adverse effects