The Clinical Relevance of the Anhepatic Phase During Liver Transplantation
| Autor: | Paul M. J. G. Peeters, Koert P. de Jong, Robert J. Porte, Maarten J.H. Slooff, Christian S. van der Hilst, Marieke T. de Boer, Alexander J. C. IJtsma |
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| Přispěvatelé: | Groningen Institute for Organ Transplantation (GIOT), Guided Treatment in Optimal Selected Cancer Patients (GUTS) |
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment Kaplan-Meier Estimate ISCHEMIA TIME Liver transplantation Risk Assessment Body Mass Index Young Adult Liver disease Risk Factors Odds Ratio medicine Hepatectomy Humans Clinical significance Warm Ischemia Young adult COLD Aged Transplantation IL-6 Hepatology business.industry Incidence Cold Ischemia CYTOKINES Perioperative Odds ratio Middle Aged medicine.disease TNF-ALPHA Liver Transplantation Surgery GRAFT FUNCTION RECIPIENTS Logistic Models Treatment Outcome IL-1-BETA Female Primary Graft Dysfunction Erythrocyte Transfusion business Body mass index |
| Zdroj: | Liver Transplantation, 15(9), 1050-1055. Wiley |
| ISSN: | 1527-6465 |
| Popis: | This study assesses the relation between the anhepatic phase duration and the outcome after liver transplantation. Of 645 patients who underwent transplantation between 1994 and 2006, 194 were recipients of consecutive adult primary piggyback liver transplants using heart-beating donors. The anhepatic phase was defined as the time from the physical removal of the liver from the recipient to recirculation of the graft. Other noted study variables were the cold and warm ischemia times, donor and recipient age, donor and recipient body mass index, perioperative red blood cell (RBC) transfusion, indication for transplantation, and Model for End-Stage Liver Disease score. The primary outcome parameter was graft dysfunction, which was defined as either primary nonfunction or initial poor function according to the Ploeg-Maring criteria. The median anhepatic phase was 71 minutes (37-321 minutes). Graft dysfunction occurred in 27 patients (14%). Logistic regression analysis showed an anhepatic phase over 100 minutes [odds ratio (OR), 4.28], a recipient body mass index over 25 kg/m(2) (OR, 3.21), and perioperative RBC transfusion (OR, 3.04) to be independently significant predictive factors for graft dysfunction. One-year patient survival in patients with graft dysfunction was 67% versus 92% in patients without graft dysfunction (P |
| Databáze: | OpenAIRE |
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