Risk factors of early liver dysfunction after liver transplantation using grafts from donation after citizen death donors |
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| Institution: | 1. Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA;2. Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA;3. Department of Surgery, University of Florida, Gainesville, FL, USA;4. Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, SC, USA;5. Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA;1. SVKM''s Dr. Bhanuben Nanavati College of Pharmacy, Mumbai 400056, India;2. Department of Pharmaceutics, SVKM''s Dr. Bhanuben Nanavati College of Pharmacy, Mumbai 400056, India;3. Department of Pharmacology, SVKM''s Dr. Bhanuben Nanavati College of Pharmacy, Mumbai 400056, India;1. Department of Gastroenterology, The 940th Hospital of Joint Service Logistics Support Force of Chinese People''s Liberation Army, Lanzhou 730050, Gansu, China;2. The First Clinical Medical College, Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China;1. Department of Bone and Joint Surgery, Wendeng Orthopaedic Hospital of Shandong Province, Shandong, China;2. Department of Orthopaedics, Qingdao Municipal Hospital, Shandong, China;3. Department of Spine and Spinal Cord, Wendeng Orthopaedic Hospital of Shandong Province, Shandong, China;4. Department of Hand and Microsurgery, Wendeng Orthopaedic Hospital of Shandong Province, Shandong, China;5. Department of Limb Trauma, Wendeng Orthopaedic Hospital of Shandong Province, Shandong, China;1. Department of Neurosurgery, Dongguan People''s Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan, Guangdong Province, China;2. Department of Neurosurgery, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Zhujiang Hospital, Southern Medical University, Guangzhou, China;3. Department of Cerebrovascular Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou 510360, Guangdong, China |
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| Abstract: | BackgroundAs an early complication after liver transplantation, early allograft dysfunction (EAD) indicates a poor prognosis. This study analyzes the risk factors related to early allograft dysfunction (EAD) after liver transplantation using grafts from donation after citizen death (DCD) to provide a reference for the prevention of EAD after DCD liver transplantation.MethodsA total of 32 patients who underwent DCD liver transplantation in the organ transplantation center of our hospital from September 2013 to January 2021 were enrolled in this study. The patients were divided into the EAD group and non-EAD group according to whether they developed EAD after transplantation. The general data of the donors and recipients before transplantation, intraoperative conditions, and clinical data within one week after transplantation were compared between the two groups, and related complications were statistically analyzed. The follow-up time was one week postoperatively or, if they died within the first week postoperatively, until the patient died.ResultsThe subjects included 10 females and 22 males, and the incidence of postoperative EAD was 25% (8/32). Four patients (12%) had primary malignant tumors (primary liver cancer and cholangiocarcinoma), and five donors (15%) had fatty liver. The univariate analysis revealed that the donor BMI (P = 0.005), degree of fatty liver (P = 0.025), aspartate aminotransferase (P = 0.001), alanine aminotransferase (P < 0.001), and total bilirubin (P = 0.009) were related to the occurrence of EAD after DCD liver transplantation. By analyzing the correlation between the incidence EAD and postoperative complications after liver transplantation using grafts from DCD donors, it was shown that the incidence of primary nonfunction (PNF) is related to EAD (P = 0.024).ConclusionDonor BMI, the degree of fatty liver, and preoperative liver function are risk factors for EAD after DCD liver transplantation, and the occurrence of EAD after DCD liver transplantation significantly increases the probability of PNF. |
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