title: Low serum factor V level: early predictor of allograft failure and death following liver transplantation.
abstract: OBJECTIVE
  According to the current criteria, the diagnosis of early allograft dysfunction usually cannot be established before the end of the first week after liver transplantation. Thus, early predictive tests for detecting allograft dysfunction are still warranted to prevent allograft failure. This study was undertaken to assess the role of low serum factor V activity as an early prognostic factor (postoperative day 2) after liver transplantation.
  
  
  METHODS
  A retrospective review of all consecutive adult patients who underwent first orthotopic whole-graft liver transplant at our institution between March 2002 and June 2011 was undertaken. Primary endpoint was graft failure within 90 days after transplantation.
  
  
  RESULTS
  Of all 105 patients analyzed in this study, 39 (37.1 %) were female and 66 (62.9 %) were male. Mean age was 52.7 ± 11.7 years, and median follow-up period was 2474 ± 164 days. There were overall 33 (31.4 %) deaths, 13 of those occurring on the first 90 post-transplant days. Multivariate analysis demonstrated that serum factor V lower than 41.5 % and female gender had a negative impact not only on allograft failure/death within 90 days after transplantation (RR = 5.30, CI = 1.40-20.2, p = 0.015 and RR = 5.23, CI = 1.53-21.33, p = 0.008) but also on overall mortality. For prediction of allograft failure/death occurring during the first 3 months, serum factor V level of 41.5 % or lower exhibited a specificity of 87.9 %, a sensitivity of 42.9 %, an accuracy of 81.9 %, a positive predictive value of 35.3 %, and a negative predictive value of 90.9 %.
  
  
  CONCLUSIONS
  Assessment of serum factor V levels on postoperative day 2 might be a promising prognostic tool for early prediction of inferior outcomes after liver transplantation.
authors.affiliation: Liver and Pancreas Transplant and Hepatobiliary Surgery Unit, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Ramiro Barcelos 2.350, 90035-903, Porto Alegre, RS, Brazil, mauriciozulian@yahoo.com.br.
authors.forename: Mauricio C
authors.initials: MC
authors.lastname: Zulian
authors.forename: Marcio F
authors.initials: MF
authors.lastname: Chedid
authors.forename: Aljamir D
authors.initials: AD
authors.lastname: Chedid
authors.forename: Tomaz J M
authors.initials: TJ
authors.lastname: Grezzana Filho
authors.forename: Ian
authors.initials: I
authors.lastname: Leipnitz
authors.forename: Alexandre
authors.initials: A
authors.lastname: de Araujo
authors.forename: Mario R
authors.initials: MR
authors.lastname: Alvares-da-Silva
authors.forename: Mario G
authors.initials: MG
authors.lastname: Cardoni
authors.forename: Luciano S
authors.initials: LS
authors.lastname: Guimaraes
authors.forename: Cleber D P
authors.initials: CD
authors.lastname: Kruel
authors.forename: Cleber R P
authors.initials: CR
authors.lastname: Kruel
mesh_terms: D064591:Allografts; D005165:Factor V / Q000032:analysis*; D005260:Female; D006084:Graft Rejection; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D005165:Factor V