Synergistic effect of cold and warm ischemia time on postoperative graft function and outcome in human liver transplantation
| Autor: | Norihisa Kimura, K. Hakamada, John J. Fung, Makoto Nakai, H. Ono, Hajime Morohashi, S. Narumi, Akimasa Nishimura, Eishi Totsuka, Satoko Morohashi, M. Sasaki, Motonari Ohashi, Katsuro Takahashi, Yoshiya Ishizawa |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Time Factors Adolescent medicine.medical_treatment Ischemia Liver transplantation Graft function Cold Ischemia Time medicine Humans Aspartate Aminotransferases Child Aged Transplantation Warm Ischemia Time business.industry Graft Survival Organ Preservation Middle Aged Hypothermia medicine.disease Liver Transplantation Treatment Outcome surgical procedures operative Anesthesia Female Surgery Liver function medicine.symptom business Follow-Up Studies |
| Zdroj: | Transplantation Proceedings. 36:1955-1958 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2004.08.068 |
| Popis: | Prolonged cold ischemia time (CIT) during graft preservation and warm ischemia time (WIT) during rewarming time have been reported to cause postoperative graft dysfunction after orthotopic liver transplantation (OLT). However, the effects of both CIT and WIT in combination on patient and graft survivals are not yet defined. The aim of this study was to determine whether simultaneously prolonged CIT and WIT were associated with early graft outcomes after clinical OLT. For analysis of liver graft survival within 90 days of OLT and postoperative graft function, 186 consecutive OLT cases were divided into four groups as follows: group A, CIT12 hours and WIT45 minutes; group B, CIT12 hours and WIT45 minutes; group C, CIT12 hours and WIT45 minutes; and group D, CIT12 hours and WIT45 minutes. The graft loss rates were 5.4% in group A, 9.8% in group B, 11.1% in group C, and 42.9% in group D. The mean highest aspartate aminotransferase (AST) value after OLT in group D (3352.3 +/- 569.4 U/L) was significantly greater than those in groups A (1411.7 +/- 169.2 U/L) and B (1931.3 +/- 362.6 U/L). The simultaneously prolonged cold and warm ischemia times significantly caused hepatic allograft injury and failure, suggesting some cumulative effects of CIT and WIT on postoperative graft function. |
| Databáze: | OpenAIRE |
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