مورد إلكتروني
Patterns of Early Allograft Dysfunction in Adult Live Donor Liver Transplantation: The A2ALL Experience.
| العنوان: | Patterns of Early Allograft Dysfunction in Adult Live Donor Liver Transplantation: The A2ALL Experience. |
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| المؤلفون: | Pomposelli, James J |
| المصدر: | Transplantation; vol 100, iss 7, 1490-1499; 0041-1337 |
| بيانات النشر: | eScholarship, University of California 2016-07-01 |
| تفاصيل مُضافة: | Pomposelli, James J Goodrich, Nathan P Emond, Jean C Humar, Abhinav Baker, Talia B Grant, David R Fisher, Robert A Roberts, John P Olthoff, Kim M Gillespie, Brenda W Merion, Robert M |
| نوع الوثيقة: | Electronic Resource |
| مستخلص: | BackgroundEarly allograft dysfunction (EAD) after living donor liver transplantation (LDLT) has often been attributed to inadequate graft size, and termed small-for-size syndrome. Early allograft dysfunction definitions include a variable constellation of findings, including hyperbilirubinemia, coagulopathy, encephalopathy, and ascites formation. Among putative causes of EAD after LDLT are excessive portal pressure and/or flow. Our objective was to evaluate patterns of EAD after LDLT.MethodsIn this study, 631 LDLT recipients were monitored for complications, EAD (defined by postoperative day 7 bilirubin >10 mg/dL or international normalized ratio >1.6), and graft failure. Approximately 200 had portal venous and arterial pressure and flow measurements before and after LDLT. Portal inflow modification (splenic artery ligation, hemiportocaval shunt, or splenectomy) was performed at the discretion of the operating surgeon. Associations between EAD and recipient, donor, and transplant factors were examined using multivariable logistic regression.ResultsRisk of EAD was associated with left lobe grafts, lower graft weight among left lobes, higher preoperative bilirubin, higher portal reperfusion pressure, higher donor age, and higher donor body mass index. The risk of graft loss within the first 90 days was 5.2 times higher for recipients with EAD versus those without EAD (P < 0.001).ConclusionsEarly allograft dysfunction can be defined using postoperative day 7 laboratory values that are highly predictive of early graft failure within 90 days. Risk factors associated with EAD after LDLT include: graft type and size, preoperative bilirubin, portal reperfusion pressure, donor age, and donor body mass index. |
| مصطلحات الفهرس: | Liver, Portal Vein, Humans, Liver Failure, Liver Transplantation, Registries, Proportional Hazards Models, Risk Factors, Cohort Studies, Age Factors, Graft Survival, Portal Pressure, Time Factors, Adult, Aged, Middle Aged, Living Donors, Female, Male, Primary Graft Dysfunction, Kaplan-Meier Estimate, Allografts, Transplantation, Digestive Diseases, Organ Transplantation, Patient Safety, Clinical Research, Cardiovascular, Liver Disease, Prevention, Medical and Health Sciences, Surgery, article |
| URL: | |
| الإتاحة: | Open access content. Open access content public |
| ملاحظة: | application/pdf Transplantation vol 100, iss 7, 1490-1499 0041-1337 |
| أرقام أخرى: | CDLER oai:escholarship.org:ark:/13030/qt6ds576f8 qt6ds576f8 https://escholarship.org/uc/item/6ds576f8Test https://escholarship.orgTest/ 1378688133 |
| المصدر المساهم: | UC MASS DIGITIZATION From OAIster®, provided by the OCLC Cooperative. |
| رقم الانضمام: | edsoai.on1378688133 |
| قاعدة البيانات: | OAIster |
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