Initial Poor Graft Dysfunction and Primary Graft Non-Function After Orthotopic Liver Transplantation

Chen, Hao; Xie, Jin; Shen, Baiyong; Deng, Xiaxing; Tao, Ran; Peng, Chenghong; Li, Hongwei

doi:10.5772/19283

Cited by 5 publications

(5 citation statements)

References 106 publications

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“…The incidence of graft dysfunction in our study group was 33%, which falls in the higher strata of the reported incidence range in the literature. 14 A comparison with other landmark LDLT studies 6 , 7 , 15 – 19 showing that our results with high EGD are not unexpected ones has been illustrated in Table 4 . The overall mortality rate was 14.6%.…”

Section: Discussionsupporting

confidence: 66%

e-GLR Score Predicts Early Graft Loss in Adult Live-Donor Liver Transplantation

Pamecha,

Patil,

Gattu

et al. 2023

Annals of Surgery Open

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Objective: This study aimed to analyze risk factors and develop a predictive model for early allograft loss due to early graft dysfunction (EGD) in adult live-donor liver transplantation (LDLT). Methods: Data of patients who underwent LDLT from 2011 to 2019 were reviewed for EGD, associated factors, and outcomes. A homogeneous group of 387 patients was analyzed: random cohort A (n = 274) for primary analysis and random cohort B (n = 113) for validation. Results: Of 274 recipients, 92 (33.6%) developed EGD. The risk of graft loss within 90 days was 29.3% and 7.1% in those with and without EGD, respectively (P < 0.001). Multivariate logistic regression analysis determined donor age (P = 0.045), estimated (e) graft weight (P = 0.001), and the model for end-stage liver disease (MELD) score (0.001) as independent predictors of early graft loss due to EGD. Regression coefficients of these factors were employed to formulate the risk model: Predicted (P) early graft loss risk (e-GLR) score = 10 × [(donor age × 0.052) + (e-Graft weight × 1.681) + (MELD × 0.145)] − 8.606 (e-Graft weight = 0, if e-Graft weight ≥640 g and e-Graft weight = 1, and if e-Graft weight < 640 g). Internal cross-validation revealed a high predictive value (C-statistic = 0.858). Conclusions: Our novel risk score can efficiently predict early allograft loss following graft dysfunction, which enables donor-recipient matching, evaluation, and prognostication simply and reliably in adult LDLT.

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Section: Discussionsupporting

confidence: 66%

e-GLR Score Predicts Early Graft Loss in Adult Live-Donor Liver Transplantation

Pamecha,

Patil,

Gattu

et al. 2023

Annals of Surgery Open

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“…Most authors over the past 20 years define IPGF as an elevation of AST or ALT of more than 1500 UI and the need of clotting support within the first days after OLT (49) . Once the MELD criterion for organ allocation was estab lished, the combination of elevated bilirubin (>10 mg/dL), INR (>1.6) and AST/ALT levels (>2000 UI/mL) after the first week of liver transplantation clearly define the patients at the greatest risk of developing PGNF and the need for retransplantation (75) .…”

Section: ) Initial Poor Graft and Primary Non-function After Liver Tmentioning

confidence: 99%

Intensive care management of patients with liver disease: proceedings of a single-topic conference sponsored by the Brazilian Society of Hepatology

Bittencourt

Terra

Parise

et al. 2015

Arq. Gastroenterol.

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Survival rates of critically ill patients with liver disease has sharply increased in recent years due to several improvements in the management of decompensated cirrhosis and acute liver failure. This is ascribed to the incorporation of evidence-based strategies from clinical trials aiming to reduce mortality. In order to discuss the cutting-edge evidence regarding critical care of patients with liver disease, a joint single topic conference was recently sponsored by the Brazilian Society of Hepatology in cooperation with the Brazilian Society of Intensive Care Medicine and the Brazilian Association for Organ Transplantation. This paper summarizes the proceedings of the aforementioned meeting and it is intended to guide intensive care physicians, gastroenterologists and hepatologists in the care management of patients with liver disease.

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“…As one of the commonest feature of ECDs, inferior outcomes was observed in patients received severe MaS allografts with more comorbidities, complications and graft failures ( Spitzer et al, 2010 ). As temporary insufficient liver function in shorter PODs, the initial poor function (IPF) was considered to be influenced by donor, recipient, graft and surgical covariates ( Hao et al, 2011 ). Usually, the IPF is reversible by intensive support within 1 month, with similar post-transplant outcomes compared to patients with immediate function ( Stockmann et al, 2010 ).…”

Section: Discussionmentioning

confidence: 99%

“…Initial poor function (IPF), usually defined with extremely higher transminase within shorter post-operative days (PODs) ( Mathe et al, 2011 ), plays determinative effect on post-transplant mortality and morbidity ( Bolondi et al, 2016 ). Risk stratification was observed on post-transplant mortality and comorbidity in patients classfied by IPF occurrence ( Maring et al, 1997 ; Hao et al, 2011 ). Donor MaS positively affects the IPF occurrence ( Hao et al, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

“…Risk stratification was observed on post-transplant mortality and comorbidity in patients classfied by IPF occurrence ( Maring et al, 1997 ; Hao et al, 2011 ). Donor MaS positively affects the IPF occurrence ( Hao et al, 2011 ). But more importantly, MaS amplified the risk of inferior prognosis with additive on IPF ( Mccormack et al, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

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Metabonomic Profile of Macrosteatotic Allografts for Orthotopic Liver Transplantation in Patients With Initial Poor Function: Mechanistic Investigation and Prognostic Prediction

Liu

Zhu

Wang

et al. 2020

Front. Cell Dev. Biol.

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Background Our previous study revealled amplified hazardous effects of macrosteatosis (MaS) on graft failure (GF) in recipients with severe liver damage in short post-operative days, with vague mechanism inside. Aim We aimed to uncover the molecular mechanism of donor MaS on GF, and construct the predictive model to monitor post-transplant prognosis based on “omics” perspective. Methods Ultra-performance liquid chromatography coupled to mass spectrometry metabolomic analysis was performed in allograft tissues from 82 patients with initial poor function (IPF) from multi-liver transplant (LT) centers. Pathway analysis was performed by on-line toolkit Metaboanalyst (v 3.0). Predictive model was constructed based on combinative metabonomic and clinical data extracted by stepwised cox proportional analysis. Results Principle component analysis (PCA) analysis revealled stratification on metabolic feature in organs classified by MaS status. Differential metabolits both associated with MaS and GF were significantly enriched on pathway of glycerophospholipid metabolism ( P < 0.05). Phosphatidylcholine (PC) and phosphatidylethanolamine (PE) involved in glycerophospholipid metabolism was significantly decreased in cases with MaS donors and GF ( P < 0.05). Better prediction was observed on graft survival by combinative model (area under the curve = 0.91) and confirmed by internal validation. Conclusion Metabonomic features of allografts can be clearly distinguished by MaS status in patients with IPF. Dysfunction on glycerophospholipid metabolism was culprit to link donor MaS and final GF. Decrement on PC and PE exerted the fatal effects of MaS on organ failure. Metabonomic data might help for monitoring long-term graft survival after LT.

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Initial Poor Graft Dysfunction and Primary Graft Non-Function After Orthotopic Liver Transplantation

Cited by 5 publications

References 106 publications

e-GLR Score Predicts Early Graft Loss in Adult Live-Donor Liver Transplantation

e-GLR Score Predicts Early Graft Loss in Adult Live-Donor Liver Transplantation

Intensive care management of patients with liver disease: proceedings of a single-topic conference sponsored by the Brazilian Society of Hepatology

Metabonomic Profile of Macrosteatotic Allografts for Orthotopic Liver Transplantation in Patients With Initial Poor Function: Mechanistic Investigation and Prognostic Prediction

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