Initial Poor Function and Primary Nonfunction in Deceased-Donor Orthotopic Liver Transplantation Maintaining Short...

Area of Science:

• Hepatology
• Transplantation Surgery
• Organ Donor Management

Background:

• Emerging liver transplant programs face challenges with deceased donor maintenance.
• Short cold ischemic time (CIT) is crucial for optimal outcomes.
• Donor factors, like acidosis, may signal poor maintenance and impact graft function.

Purpose of the Study:

• To analyze extended criteria donor factors influencing primary nonfunction (PNF) and initial poor function (IPF).
• To quantify the risk of PNF and IPF associated with donor acidosis and other factors.

Main Methods:

• Single-center retrospective analysis of deceased-donor liver transplantations over two years.
• Prospective data collection on patient outcomes.
• Evaluation of extended criteria donor factors, including donor acidosis.

Main Results:

• No cases of primary nonfunction (PNF) were observed.
• Initial poor function (IPF) occurred in 15.5% of recipients.
• Graft macrosteatosis and donor acidosis were significantly associated with IPF (P=.002 and P=.032).
• Cold ischemic time was consistently short (≤8 hours in 81 cases).

Conclusions:

• Poor donor maintenance, indicated by donor acidosis and graft macrosteatosis, significantly impacts IPF risk even with short CIT.
• Larger studies are necessary to establish definitive extended criteria cutoff values.