Analysis of the Predictive Ability for Graft Loss and Mortality of Two Criteria for Early Allograft Dysfunction After Liver Transplantation

Brea-Gómez, Esther; Villar-Quintana, R.; Plata-Illescas, C.; Zambudio-Carroll, N.; López-Garrido, Miguel A.; Nogueras-López, Flor; Muffak-Granero, K.; Becerra-Massare, Antonio; Villegas-Herrera, M.T.; Jiménez, Inmaculada Segura; Pérez, Nuria Muñoz; Villar-del-Moral, Jesús

doi:10.1016/j.transproceed.2017.11.057

Cited by 6 publications

(5 citation statements)

References 8 publications

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“…A lot of studies [10][11][12] have found that even when Olthoff and MEAF scores overlap in the diagnosis of EAD, MEAF is still superior due to the fact that it is calculated on the 3rd day, while…”

Section: Based On the Results Shown Inmentioning

confidence: 99%

The efficacy of two models – MEAF and pMELD, as indicators of lethal outcome in early postoperative period after liver transplantation in children

Goncharov,

Uzunova

2023

COT

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The current study is aiming to prove the effectiveness and compare “Model for Early Allograft Function” (MEAF) and “postoperative Model for End-stage Liver Disease” (pMELD) in the early posttransplant setting in children. Methods. We did a retrospective study on 43 liver transplant patients for a 17-year period between the ages 0 – 18 years. MEAF and pMELD were calculated on the third and fifth postoperative day, respectively, and a Cox regression analysis was performed to find the correlation between them and mortality in the early postoperative period (EPOP). Results. Both scores proved to be statistically significant and applicable in EPOP. MEAF had P value of 0.0003 and a hazard ratio of 10.99, while pMELD demonstrated P value of 0.003 and a hazard ratio of 1.24. Conclusions. Both MEAF and pMELD can be used for the diagnostics of early allograft dysfunction and predicting the outcome of the transplantation, with MEAF having the upper hand.

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Section: Based On the Results Shown Inmentioning

confidence: 99%

The efficacy of two models – MEAF and pMELD, as indicators of lethal outcome in early postoperative period after liver transplantation in children

Goncharov,

Uzunova

2023

COT

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“…Gomez et al concluded that MEAF score and Olthoff criteria are both helpful methods for the identification of EAD. They claimed that with the latter, patients at risk could be selected more accurately, but its calculation cannot be done before the seventh day after OLT, unlike MEAF score, which is available on the third day (1). The main benefit of the MEAF score is its continuous nature, which enables patients to be categorised according to the severity of EAD rather than simply being classified into two groups (7).…”

Section: Discussion Discussionmentioning

confidence: 99%

“…The disparity between donor numbers and patients on the OLT waiting list has led transplant units to expand the criteria for donor liver allograft acceptance to include donation after circulatory death (DCD) and older age of donors, increasing the chance of unfavourable consequences (1). Ischemic injury, particularly warm ischaemic injury, which is inevitable during liver procurement and subsequent implantation, increases the risk of primary nonfunction, early allograft dysfunction, and affects overall graft and patient survival (2,3,4).…”

Section: Introduction Introductionmentioning

confidence: 99%

Does Donor Liver Extraction Time Affect Early Allograft Function in Deceased Adult Liver Transplant Recipients?

Ghazaly¹,

Surendrakumar²,

Tiwari³

et al. 2020

SGO

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Background: Recent work has identified time taken to remove a donor liver during organ retrieval (the extraction time) as a previously unrecognized variable affecting transplant outcome. We evaluated the effect of extraction time on early graft function in our own practice in a busy liver centre. Patients and Methods: 218 recipients of liver grafts transplanted at our centre (Addenbrooke's, Cambridge) between October 2014 and October 2017 were evaluated. Early graft function was assessed by model for early allograft function (MEAF) score in both univariate and multivariate analysis including other variables known to affect outcome such as cold ischaemia time (CIT), warm ischaemia time (WIT), operative time, and terminal donor sodium concentration. Results: In univariate analysis, extraction time, and CIT had a significant independent effect on MEAF score (P= 0.041, 0.008). Both prolonged donor extraction time and CIT were independently associated with a significant increase in the MEAF score in multivariate analysis {(95% confidence interval, 0.136 -0.563; P = 0.044), (95% confidence interval, 0.239-0.761; P = 0.011)}. Conclusion: Donor liver extraction time has an independent effect on early graft function in deceased donor liver transplantation. Shortening donor extraction time during liver procurement could decrease the incidence of early allograft dysfunction.

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“…However, due to the shortage of liver allografts, more extended standard allografts have been used in the clinic ( 2 ). There are still many complications associated with LT, such as early allograft dysfunction (EAD), which represents higher mortality and graft failure ( 3 ). A few patients with EAD could gradually develop into primary graft nonfunction, which is the most serious complication after orthotropic liver transplantation and often requires surgery again, with high clinical mortality ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

Postoperative serum myoglobin as a predictor of early allograft dysfunction after liver transplantation

Zhang

Han

et al. 2022

Front. Surg.

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BackgroundEarly allograft dysfunction (EAD) is a common postliver transplant complication that has been associated with graft failure and risk for poor prognosis. There are many risk factors for the incidence of EAD after liver transplantation (LT). This study investigated whether elevated postoperative myoglobin (Mb) increases the incidence of EAD in liver transplanted recipients.MethodsA total of 150 adult recipients who measured Mb within 3 days after liver transplantation between June 2019 and June 2021 were evaluated. Then, all patients were divided into two groups: the EAD group and the non-EAD group. Univariate and multivariate logistic regression analyses were performed, and receiver operating characteristic curves (ROCs) were constructed.ResultsThe incidence of EAD was 53 out of 150 patients (35.3%) in our study. Based on the multivariate logistic analysis, the risk of EAD increased with elevated postoperative Mb (OR = 1.001, 95% CI 1.000–1.001, P = 0.002). The Mb AUC was 0.657, and it was 0.695 when combined with PCT. When the subgroup analysis was conducted, the AUC of serum Mb prediction was better in patients whose preoperative model for end-stage liver disease score ≤ 15 or operative time ≥ 10 h (AUC = 0.751, 0.758, respectively, or 0.760, 0.800 when combined with PCT).ConclusionElevated Mb significantly increased the risk of postoperative EAD, suggesting that postoperative Mb may be a novel predictor of EAD after liver transplantation.The study was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2100044257, URL: http://www.chictr.org.cn).

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Analysis of the Predictive Ability for Graft Loss and Mortality of Two Criteria for Early Allograft Dysfunction After Liver Transplantation

Cited by 6 publications

References 8 publications

The efficacy of two models – MEAF and pMELD, as indicators of lethal outcome in early postoperative period after liver transplantation in children

The efficacy of two models – MEAF and pMELD, as indicators of lethal outcome in early postoperative period after liver transplantation in children

Does Donor Liver Extraction Time Affect Early Allograft Function in Deceased Adult Liver Transplant Recipients?

Postoperative serum myoglobin as a predictor of early allograft dysfunction after liver transplantation

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