Primary Nonfunction and Early Allograft Dysfunction after Liver Transplantation

Background: Despite continuous progress in the field of liver transplantation, considerable proportion of patients still suffer from the post-operative graft dysfunction. Clinically it presents as early graft dysfunction (EAD) and its more severe form defined as primary non-function (PNF). Post-transplant liver dysfunction translates into significantly worse treatment outcomes. Summary: Both entities are multifactorial, with donor (graft), recipient and procedure related factors playing the key roles. Ischemia reperfusion injury (IRI) is a major driver of their development. So far, various non-invasive (pharmacological) and invasive strategies have been tested to mitigate its negative effects. This article presents current approach to diagnosis, prediction and management of EAD and PNF. Key messages: Different pharmacological interventions may be considered to improve graft function after liver transplantation. Machine perfusion seems to be the most effective method at the moment.