Early graft dysfunction following adult-to-adult living-related liver transplantation: Predictive factors and outcomes

Abstract

AIM:To describe a condition that we define as early graft dysfunction (EGD) which can be identified preoperatively. METHODS:Small-for-size graft dysfunction following living-related liver transplantation (LRLT) is characterized by EGD when the graft-to-recipient body weight ratio (GRBWR) is below 0.8%. However, patients transplanted with GRBWR above 0.8% can develop dysfunction of the graft. In 73 recipients of LRLT (GRBWR > 0.8%), we identified 10 patients who developed EGD. The main measures of outcomes analyzed were overall mortality, number of re-transplants and length of stay in days (LOS). Furthermore we analyzed other clinical pre-transplant variables, intraoperative parameters and post transplant data. RESULTS:A trend in favor of the non-EGD group (3-mo actuarial survival 98% vs 88%, P = 0.09; 3-mo graft mortality 4.7% vs 20%, P = 0.07) was observed as well as shorter LOS (13 d CONCLUSION: EGD can be identified preoperatively and is associated with increased morbidity after LRLT. A prompt recognition of EGD can trigger a timely treatment.

Assessment of Graft Selection Criteria in Living-Donor Liver Transplantation: The Jikei Experience

“…Moreover, splenic artery embolization has been described as a therapeutic application for smallfor-size syndrome. 12 The model for end-stage liver disease-Na score and preoperative serum platelet counts as risk factors of early graft dysfunction, 13 and importance of avoidance of hepatitis C virusinfected living-donor liver donation have also been described. 14 In conclusion, our medical requirements for living liver donation seem to be acceptable, because of the good outcome.…”

A New Formula as a Predictive Score of Post–Liver Transplantation Outcome: Postoperative MELD-Lactate

“…Early graft function after liver transplantation is an important prognostic marker for individual outcome [24], and initial poor graft function may be related not only to quality of the donor organ but also to secondary complications such as renal failure, severe bleeding, and septic infections, resulting in a negative effect on long-term patient health and employment [25].…”

Outcome after living donor liver transplantation: A comprehensive retrospective analysis of the risk factors for morbidity, mortality and graft failure in a tertiary care center

“…Adequate selection of both the donor and the recipient for LDLT is very important factor to prevent mortality and morbidity including graft failure and the need for retransplantation [2,5]. Few studies have investigated factors leading to graft failure especially with LDLT [17]. Several risk factors for graft loss after LDLT were identified by researchers as donor age [18], MELD score [19][20][21][22][23], intraoperative blood loss [23][24][25], warm ischemic time [25], and small for size syndrome [26][27][28][29].…”