Recipient and Perioperative Risk Factors Associated With Liver Transplant Graft Outcomes

• Published in: Transplantation proceedings 2012-03, Vol.44 (2), p.505-508
• Main Authors: Sirivatanauksorn, Y, Taweerutchana, V, Limsrichamrern, S, Kositamongkol, P, Mahawithitwong, P, Asavakarn, S, Tovikkai, C
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Blood Loss, Surgical; Chi-Square Distribution; Epidemiology; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; General aspects; Humans; Incidence; Liver Transplantation - adverse effects; Liver, biliary tract, pancreas, portal circulation, spleen; Logistic Models; Male; Medical sciences; Middle Aged; Odds Ratio; Primary Graft Dysfunction - epidemiology; Primary Graft Dysfunction - etiology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies; Risk Assessment; Risk Factors; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Thailand; Time Factors; Tissue Donors; Tissue, organ and graft immunology; Treatment Outcome; Warm Ischemia - adverse effects
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2012.01.065

Abstract Background Orthotopic Liver transplantation (OLT) is currently considered to be the ultimate form of therapy for most patients with end-stage liver diseases. The identification of recipient and various perioperative factors that may affect the graft outcomes is critical. This study sought to analyze the preoperative and perioperative factors associated with graft outcomes in our institute. Methods This retrospective study of liver transplanted patients from January 2002 to December 2009 determined the incidence of 2 forms of primary dysfunction (PDF): Primary nonfunction (PNF) and initial poor function (IPF). Results The 97 posttransplant patients included in the study had an average age of 52.74 years. The majority of indications for OLT were hepatitis B and/or C cirrhosis, alcoholic cirrhosis, and hepatocellular carcinoma. The incidence of PDF was 31.9% (31/97) with 7.2% (7/97) PNF and 24.7% (24/97) IPF. Additionally, we observed 68.1% (66/97) to display immediate function (IF). Warm ischemic time (WIT) and operative time were significantly longer in the PDF compared with the IF group. The logistic regression model showed a WIT of >45 minutes to be a risk factor leading to PDF (odds ratio, 11.74; P < .05). An operative time of >6 hours and operative blood loss of >2 L were possible risk factors. Conclusion Prolonged WIT (>45 minutes) was the only significant risk factor among other established parameters for graft function. Nevertheless, reduced operative times and blood loss may improve the outcomes of OLT.