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Effect of early allograft dysfunction on outcomes following liver transplantation
Author(s) -
Hudcova Jana,
Scopa Caitlin,
Rashid Jawad,
Waqas Ahsan,
Ruthazer Robin,
Schumann Roman
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12887
Subject(s) - medicine , hazard ratio , proportional hazards model , multivariate analysis , cohort , liver transplantation , pacu , surgery , transplantation , univariate analysis , retrospective cohort study , gastroenterology , confidence interval
Early allograft dysfunction ( EAD ) following liver transplantation ( LT ) remains a challenge for patients and clinicians. We retrospectively analyzed the effect of pre‐defined EAD on outcomes in a 10‐year cohort of deceased‐donor LT recipients with clearly defined exclusion criteria. EAD was defined by at least one of the following: AST or ALT >2000 IU /L within first‐week post‐ LT , total bilirubin ≥10 mg/ dL , and/or INR ≥1.6 on post‐operative day 7. Ten patients developed primary graft failure and were analyzed separately. EAD occurred in 86 (36%) recipients in a final cohort of 239 patients. In univariate and multivariate analyses, EAD was significantly associated with mechanical ventilation ≥2 days or death on days 0, 1, PACU / SICU stay >2 days or death on days 0‐2 and renal failure ( RF ) at time of hospital discharge (all P <.05). EAD was also significantly associated with higher one‐year graft loss in both uni‐ and multivariate Cox hazard analyses ( P =.0203 and .0248, respectively). There was no difference in patient mortality between groups in either of the Cox proportional hazard models. In conclusion, we observed significant effects of EAD on short‐term post‐ LT outcomes and lower graft survival.