Multi-factor analysis of initial poor graft function after orthotopic liver transplantation

Area of Science:

• Hepatology
• Transplantation Surgery
• Clinical Risk Factor Analysis

Background:

• Initial poor graft function (IPGF) is a significant complication following orthotopic liver transplantation (OLT).
• IPGF can escalate to primary graft non-function (PGNF) in severe instances.
• Identifying clinical risk factors for IPGF is crucial for improving OLT outcomes.

Purpose of the Study:

• To determine the clinical risk factors associated with initial poor graft function (IPGF) after orthotopic liver transplantation (OLT).

Main Methods:

• Analysis of 80 OLT cases, categorizing patients into IPGF (ALT/AST > 1500 IU/L within 72 hours) and non-IPGF groups.
• Evaluation of recipient factors (age, sex, liver disease, Child-Pugh class) and peri-operative factors (non-heart beating donor time [NHBT], cold ischemia time [CIT], rewarming ischemic time [RWIT]).
• Logistic regression modeling to identify significant risk factors for IPGF.

Main Results:

• The IPGF group exhibited significantly longer NHBT, CIT, and RWIT compared to the non-IPGF group.
• NHBT was identified as a significant risk factor for IPGF (P<0.05) via logistic regression.
• CIT and RWIT emerged as potential risk factors, with one case of PGNF associated with moderate hepatic steatosis.

Conclusions:

• Extended non-heart beating donor time (NHBT) is a primary risk factor for initial poor graft function (IPGF) in OLT.
• Donor liver steatosis, CIT, and RWIT are identified as potential contributing risk factors for IPGF.