-
Observational Study
Analysis of the Predictive Ability for Graft Loss and Mortality of Two Criteria for Early Allograft Dysfunction After Liver Transplantation.
- E Brea-Gómez, R Villar-Quintana, C Plata-Illescas, N Zambudio-Carroll, M A Lopez-Garrido, F Nogueras-Lopez, K Muffak-Granero, A Becerra-Massare, M T Villegas-Herrera, I Segura Jiménez, N Muñoz Pérez, and J M Villar-Del-Moral.
- Liver Transplant Unit, General Surgery Department, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: estherbre@hotmail.com.
- Transplant. Proc. 2018 Mar 1; 50 (2): 605-609.
IntroductionThe current imbalance between available donors and potential recipients for orthotopic liver transplantation (OLT) has led to a liberalization of organ acceptance criteria, increasing the risk of post-transplant complications such as early allograft dysfunction (EAD). Consequently, we need accurate criteria to detect patients with early poor graft function to guide the strategies of management. We evaluated the usefulness of two frequently used criteria: the definition from Olthoff et al and the Model for Early Allograft Function (MEAF) scoring.Patients And MethodsUnicentric cohort study of patients undergoing OLT between January 1, 2010, and November 20, 2016. We performed a univariate study to detect donor, recipient, and transplant factors favoring EAD, defined both by Olthoff criteria and a MEAF score higher than 7. Finally, we developed a comparative survival analysis for cases having or not EAD.ResultsIn all, 201 transplants met inclusion criteria. According to the stated cutoff for MEAF score, the frequency of EAD was 9.3%, with a significant association to low recipient body mass index and prolonged total graft ischemia time, resulting in lower patient 3-month postoperative survival. According to Olthoff criteria, EAD incidence was 22.1% and was associated with younger donor and recipient ages and higher Model for End-stage Liver Disease and Child-Pugh recipient scores. Its development resulted in lower graft and recipient survival at 3 months after OLT.ConclusionMEAF score and Olthoff criteria are useful tools for detection of EAD. The latter could select more appropriately patients at risk, but its calculation cannot be done until the seventh day after OLT, unlike MEAF score, available on third day.Copyright © 2017 Elsevier Inc. All rights reserved.
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