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, intra-operative 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 vs 41.5 d; P = 0.001) and smaller requirement of peri-operative Units of Plasma (4 vs 14; P = 0.036). Univariate analysis of pre-transplant variables identified platelet count, serum bilirubin, INR and Meld-Na score as predictors of EGD. In the multivariate analysis transplant Meld-Na score (P = 0.025, OR: 1.175) and pre-transplant platelet count (P = 0.043, OR: 0.956) were independently associated with EGD.CONCLUSION: EGD can be identified preoperatively and is associated with increased morbidity after LRLT. A prompt recognition of EGD can trigger a timely treatment.
展开▼
机译：目的：描述一种我们可以定义为可以在术前识别的早期移植物功能障碍（EGD）的疾病。方法：与生活相关的肝移植（LRLT）后的小尺寸移植物功能障碍的特征在于，当移植至受者体重比（GRBWR）低于0.8％。但是，移植GRBWR高于0.8％的患者会出现移植物功能障碍。在73名LRLT接受者（GRBWR> 0.8％）中，我们确定了10例发生EGD的患者。分析结果的主要指标是总死亡率，再移植次数和住院天数（LOS）。此外，我们分析了其他临床移植前变量，术中参数和移植后数据。结果：倾向于非EGD组的趋势（3-mo精算生存率98％vs 88％，P = 0.09; 3-mo移植物死亡率为4.7％vs 20％，P = 0.07），LOS较短（13 d vs 41.5 d； P = 0.001），围手术期血浆需求量较小（4 vs 14； P = 0.036）。移植前变量的单变量分析确定了血小板计数，血清胆红素，INR和Meld-Na评分是EGD的预测指标。在多变量分析中，移植物的Meld-Na评分（P = 0.025，OR：1.175）和移植前的血小板计数（P = 0.043，OR：0.956）与EGD独立相关。结论：EGD可在术前鉴定并与EGD相关LRLT后发病率增加。迅速识别EGD可触发及时治疗。
展开▼
