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Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model

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Early graft dysfunction after liver transplant: Comparison of different diagnostic criteria in a single-center

J E Barrueco-Francioni¹, G Seller-Pérez², R Lozano-Saéz²

¹Intensive Care Medicine Unit, Regional University Hospital of Malaga, Spain; Faculty of Medicine, University of Malaga, Spain.

Medicina Intensiva

|December 12, 2018

Abstract

Objective:

Comparison of different diagnostic criteria for early liver allograft dysfunction (EAD) and their capability to predict mortality.

Design:

Single-center, prospective, cohort study.

Settings:

ICU in a Regional Hospital with a liver transplant program since 1997.

Patients:

253 consecutive patients admitted to our ICU immediately after liver transplantation between 2009 and 2015.

Variables Of Interest:

Differences in the incidence of EAD and its relation with ICU, Hospital and 2-year mortality depending on the definition applied using as comparator the UNOS (United Network for Organ Sharing) primary non-function criterion.

Results:

The incidence of early liver allograft dysfunction according to UNOS was 13.8%, to Makowka 6.3%, to Ardite 10.7%, to Nanashima 20.6%, to Dhillon 30.8% and to MEAF 13.4%. Kappa test did not show a good correlation among these criteria. EAD was related with ICU mortality for all diagnostic criteria except Dhillon but only UNOS, Makowka and MEAF were associated with 2-year mortality. Hospital mortality was poorly predicted by all criteria except for the MEAF score.

Conclusion:

We found a poor agreement between different criteria analyzed for the diagnosis of EAD. In our population, the MEAF score showed the best relationship with short- and long-term mortality.

Keywords:

Complicaciones postoperatorias Criterion Criterios Disfunción primaria del injerto Fallo primario Liver transplantation Mortalidad Mortality Outcome Postoperative complication Primary graft dysfunction Primary non function Resultado Trasplante hepático

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