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

Autor: Barrueco-Francioni JE; Intensive Care Medicine Unit, Regional University Hospital of Malaga, Spain; Faculty of Medicine, University of Malaga, Spain., Seller-Pérez G; Intensive Care Medicine Unit, Regional University Hospital of Malaga, Spain., Lozano-Saéz R; Intensive Care Medicine Unit, Regional University Hospital of Malaga, Spain., Arias-Verdú MD; Intensive Care Medicine Unit, Regional University Hospital of Malaga, Spain., Quesada-García G; Intensive Care Medicine Unit, Regional University Hospital of Malaga, Spain., Herrera-Gutiérrez ME; Intensive Care Medicine Unit, Regional University Hospital of Malaga, Spain; Faculty of Medicine, University of Malaga, Spain. Electronic address: mehguci@gmail.com.
Jazyk: English; Spanish; Castilian
Zdroj: Medicina intensiva [Med Intensiva (Engl Ed)] 2020 Apr; Vol. 44 (3), pp. 150-159. Date of Electronic Publication: 2018 Oct 24.
DOI: 10.1016/j.medin.2018.09.004
Abstrakt: 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.
(Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.)
Databáze: MEDLINE
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