Treatment of Primary Liver Graft Nonfunction With Prostaglandin E1

Greig, Paul D.; Woolf, Graham M.; Sinclair, S.; Abecassis, Michael; Strasberg, Steven M.; Taylor, Bryce; Blendis, Laurence M.; Superina, Riccardo; Glynn, Michael; Langer, Bernard; Levy, Gary

doi:10.1097/00007890-198909000-00020

Cited by 256 publications

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“…The presence of PI in the 0Post biopsy strongly vesicular steatosis, ABO blood group incompatibility, and docorrelated with the development of PI during POD 2 nor age over 50 years. [1][2][3][4][5][6][7][8][9][10][11][12] Additional risk factors include through 14 (P õ .0005). Peak AST and ALT values in retransplantation, markedly elevated donor transaminase patients with moderate-to-severe PI on POD 2 through levels, the use of pressors in the donor, and the use of re-14 were significantly elevated compared with those pa-duced-size liver grafts.…”

Section: Histological Pi Compared With 48 (70%) Of the 0post Biop-mentioning

confidence: 99%

“…Only 2 of 25 (8%) plantation, elevated donor transaminase levels, and the use of reduced-size liver grafts. [1][2][3][4][5][6][7][8][9][10][11][12] These factors were minimized of the 0Pre biopsies showed evidence of ischemic damage and the remainder were histologically normal; these specimens in the current patients; nonetheless, some degree of PI was histologically documented in the majority of patients in whom were excluded from further analysis. In contrast, 48 of 69 (70%) 0Post biopsies showed variable degrees of sinusoidal a POD 2 through 14 biopsy was available.…”

Section: The Development Of Pi During Pod 2 Through 14 Correlatedmentioning

confidence: 99%

“…8 These and other studies, however, defined IPF on Abbreviations: PI, preservation injury; IPF, initial poor function; ALT, alanine transamithe basis of elevated liver function tests alone. 1,6,8,10,11 Benase; AST, aspartate transaminase; PT, prothrombin time; POD, postoperative day; 0Post, cause elevated liver function tests following transplantation liver allograft biopsy obtained after revascularization and reperfusion of the allograft; 0Pre, may result from complications other than PI (e.g., infection, liver allograft biopsy obtained on day 0 after cold preservation but before reperfusion.From the Departments of 1 Pathology, 2 Internal Medicine, and 3 Transplantation Surgery, early acute cellular rejection, and hepatic artery thrombosis), Pathology, …”

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confidence: 99%

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Predictive Value of Intraoperative Biopsies and Liver Function Tests for Preservation Injury in Orthotopic Liver Transplantation

et al. 1997

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and ALT values are not useful in the assessment of PI. Eighty liver allografts were studied to determine the (HEPATOLOGY 1997;25:184-189 .) predictive value of intraoperative biopsies and postoperative liver function tests for the development of preservation injury (PI). Peak transaminase (aspartate transaminase [AST] and alanine transaminase [ALT])Graft viability is of the utmost importance for successful and prothrombin time (PT) values achieved by each pa-orthotopic liver transplantation. Virtually all liver allografts tient during postoperative days (POD) 1 through 7 were are injured during transplantation, either as a result of determined. PI in day 0 preperfusion biopsies (0Pre) (ob-events leading to donor death, donor life support, or during tained immediately before implantation) and postperfu-the process of allograft extraction, cold preservation, implansion biopsies (0Post) (obtained immediately after revas-tation, hypoxic rewarming, and reperfusion. Allograft injury cularization) was categorized by histological criteria as resulting from the transplantation process is commonly represent or absent. PI in biopsies taken during POD 2 ferred to as preservation injury (PI). Preservation injury is through 14 was histologically graded as either moderate-a major contributor to primary allograft dysfunction, a term to-severe, mild, or absent. Of the 80 allografts, 8 were encompassing both primary nonfunction, defined as complete omitted because of primary nonfunction or postopera-allograft failure in the absence of apparent technical or imtive complications. 0Pre and 0Post biopsies were avail-munologic complications, and initial poor function (IPF), deable on 25 of 72 (35%) and 69 of 72 (96%) allografts, respec-fined as borderline graft function immediately after transtively. Only 2 (8%) of the 0Pre biopsies showed plantation. histological PI compared with 48 (70%) of the 0Post biop-Several studies have attempted to identify donor, intraopsies. Fifty-nine patients were biopsied between POD 2 erative, and recipient factors predictive of primary allograft through 14. Of these, 15, 28, and 16 patients developed dysfunction. Primary dysfunction has been consistently assomoderate-to-severe, mild, or no evidence of PI, respec-ciated with prolonged cold and warm ischemia, severe macrotively. The presence of PI in the 0Post biopsy strongly vesicular steatosis, ABO blood group incompatibility, and docorrelated with the development of PI during POD 2 nor age over 50 years. [1][2][3][4][5][6][7][8][9][10][11][12] Additional risk factors include through 14 (P õ .0005). Peak AST and ALT values in retransplantation, markedly elevated donor transaminase patients with moderate-to-severe PI on POD 2 through levels, the use of pressors in the donor, and the use of re-14 were significantly elevated compared with those pa-duced-size liver grafts. 1-12 Despite efforts to avoid using donor tients with either mild (P Å .01 and .03) or no PI (P Å .02 organs with these and other potentially adverse variables, and .006). Because of ext...

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Section: Histological Pi Compared With 48 (70%) Of the 0post Biop-mentioning

confidence: 99%

Section: The Development Of Pi During Pod 2 Through 14 Correlatedmentioning

confidence: 99%

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confidence: 99%

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Predictive Value of Intraoperative Biopsies and Liver Function Tests for Preservation Injury in Orthotopic Liver Transplantation

et al. 1997

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“…In addition, clearance of lactic acidosis, awakening from the anesthetized state, and good renal function provide further affirmation of liver function. Primary nonfunction of the graft will lead to graft failure and need for retransplantation [13].…”

Section: Liver Functionmentioning

confidence: 99%

Liver Transplantatation- an Overview

Rai

2012

Indian J Surg

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Liver transplantation is a therapeutic option of choice for acute and chronic end-stage liver disease. Indications, contraindications, and surgical procedures for the liver transplantation have become well established. In most part of the world, the main source of liver for transplantation remains the donation after brain death (DBD), but in view of increasing death on the waiting list due to shortage of brain dead organs other options such as split liver transplantation, living donor liver transplantation (LDLT), and donation after cardiac death (DCD) have been used. In the pretransplantation era, liver failure was nearly universally fatal, with mortality from fulminant hepatic failure of 80-90 %, and 1-year mortality in decompensated cirrhosis of more than 50 %. In contrast, liver transplantation patient survival is presently more than 85 % at 1 year and more than 70 % at 5 years, emphasizing the clinical benefit of liver transplantation for either acute or chronic liver failure.

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“…Olmedilla et al 2 performed a large single-center study with 172 liver recipients and compared posttransplant ICG-PDR values with the graft function score (grades I-IV) developed by Greig et al 3 However, Greig et al's classification is only one exemplary score among various others and had already been developed in the period of 1985-1988. 3 Thereafter, more scores, using different specific patterns of biochemical and clinical parameters of the early posttransplant period, were developed for the same purpose.…”

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confidence: 99%