| Revue: | Annals of hepatology |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000413416 |
| ISSN: | 1665-2681 |
| Autores: | Lee, David D1 Croome, Kristopher P1 Shalev, Jefree A1 Musto, Kaitlyn R1 Sharma, Meenu1 Keaveny, Andrew P1 Taner, C. Burcin1 |
| Instituciones: | 1Mayo Clinic Florida, Department of Transplant, Jacksonville, Florida. Estados Unidos de América |
| Año: | 2016 |
| Periodo: | Ene-Feb |
| Volumen: | 15 |
| Número: | 1 |
| Paginación: | 53-60 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico, descriptivo |
| Resumen en inglés | The Background. term early allograft dysfunction (EAD) identifies liver transplant (LT) allografts with initial poor function and portends poor allograft and patient survival. Aims of this study are to use EAD as an intermediate outcome measure in a large single center cohort and identify donor, recipient and peri-operative risk factors. Material and methods. Material and methods. Material and methods. In 1950 consecutive primary LT, donor, recipient and peri-operative data were collected. EAD was defined by the presence of one or more of the following: total bilirubin ≥ 10 mg/dL (171 μmol/L) or, INR ≥ 1.6 on day 7, and ALT/AST > 2,000 IU/L within the first 7 days. Results. Results. Results. The incidence of EAD was 26.5%. 1-, 3-, and 5-year allograft and patient survival for patients who developed EAD were significantly inferior to those who did not (P < 0.01 at all time points). Multivariate analysis demonstrated associations in the development of EAD with recipient pre-operative ventilator status, donation after cardiac death allografts, donor age, allograft size, degree of steatosis, operative time and intra-operative transfusion requirements (all P < 0.01). Patients with EAD had a significantly longer hospitalization at 20.9 ± 38.9 days (median: 9; range: 4-446) compared with 10.7 ± 13.5 days (median: 7; range: 3-231) in patients with no EAD (P < 0.01). Conclusions. Conclusions. Conclusions. This is the largest single center experience demonstrating incidence of EAD and identifying factors associated with development of EAD. EAD is a useful intermediate outcome measure for allograft and patient survival. Balancing recipient pretransplant conditions, donor risk factors and intra-operative conditions are necessary for avoiding EAD |
| Disciplinas: | Medicina |
| Palabras clave: | Cirugía, Gastroenterología, Inmunología, Trasplante de hígado, Disfunción temprana de aloinjerto, Sobrevivencia, Selección de donantes |
| Keyword: | Medicine, Gastroenterology, Surgery, Immunology, Liver transplantation, Early allograft dysfunction, Survival, Donor selection |
| Texte intégral: | Texto completo (Ver PDF) |
