Recipient-Related Preoperative and Intraoperative Risk Factors for Primary Graft Dysfunction After Orthotopic Liver...

Area of Science:

• Hepatology
• Transplantation immunology
• Surgical outcomes

Background:

• Primary graft dysfunction (PGD) is a significant complication following liver transplantation, leading to adverse outcomes.
• Ischemia-reperfusion injury is a primary driver of PGD.
• PGD encompasses early allograft dysfunction and primary nonfunction within the first seven days post-transplant.

Purpose of the Study:

• To identify preoperative and intraoperative risk factors associated with PGD after liver transplantation.
• To elucidate predictors of primary graft dysfunction in liver transplant recipients.

Main Methods:

• Retrospective analysis of 109 patients undergoing orthotopic liver transplantation (2012-2016).
• Inclusion of biochemical parameters, morphology, blood transfusions, and intraoperative blood pressure.
• Logistic regression and ROC analysis to determine independent risk factors.

Main Results:

• Fourteen percent of patients developed PGD.
• Elevated preoperative neutrophil count (>4030/μL) was a significant independent risk factor (OR=4.03, P=.012).
• A decrease in mean arterial pressure post-reperfusion was also identified as a major PGD risk factor.

Conclusions:

• High preoperative neutrophil levels may represent a novel recipient-related risk factor for PGD.
• Reduced arterial blood pressure following graft reperfusion is implicated in PGD development.
• These findings can inform risk stratification and management strategies for liver transplant recipients.