• Dieter P Hoyer, Andreas Paul, Anja Gallinat, Ernesto P Molmenti, Renate Reinhardt, Thomas Minor, Fuat H Saner, Ali Canbay, Jürgen W Treckmann, Georgios C Sotiropoulos, and Zoltan Mathé.
• Department of General, Visceral and Transplantation Surgery, University Hospital, Essen, Germany.
• Liver Int. 2015 Jan 1; 35 (1): 156-63.

Background & AimsPoor initial graft function was recently newly defined as early allograft dysfunction (EAD) [Olthoff KM, Kulik L, Samstein B, et al. Validation of a current definition of early allograft dysfunction in liver transplant recipients and analysis of risk factors. Liver Transpl 2010; 16: 943]. Aim of this analysis was to evaluate predictive donor information for development of EAD.MethodsSix hundred and seventy-eight consecutive adult patients (mean age 51.6 years; 60.3% men) who received a primary liver transplantation (LT) (09/2003-12/2011) were included. Standard donor data were correlated with EAD and outcome by univariable/multivariable logistic regression and Cox proportional hazards to identify prognostic donor factors after adjustment for recipient confounders. Estimates of relevant factors were utilized for construction of a new continuous risk index to develop EAD.Results38.7% patients developed EAD. 30-day survival of grafts with and without EAD was 59.8% and 89.7% (P < 0.0001). 30-day survival of patients with and without EAD was 68.5% and 93.1% (P < 0.0001) respectively. Donor body mass index (P = 0.0112), gGT (P = 0.0471), macrosteatosis (P = 0.0006) and cold ischaemia time (CIT) (P = 0.0031) were predictors of EAD. Internal cross validation showed a high predictive value (c-index = 0.622).ConclusionsEarly allograft dysfunction correlates with early results of LT and can be predicted by donor data only. The newly introduced risk index potentially optimizes individual decisions to accept/decline high risk organs. Outcome of these organs might be improved by shortening CIT.© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

25 keywords...

hide…