Clinical analysis of early allograft dysfunction in patients receiving donation after cardiac death liver Transplantation / 中华器官移植杂志

ABSTRACT

Objective To investigate the occurrence and influencing factors of early allograft dysfunction (EAD) in patients receiving donation after cardiac death (DCD) liver Transplantation.Methods Forty-five patients received orthotopic liver transplantation in our center during January 2016 and May 2016 were included in this study.Based on the occurrence of EAD,patients were divided into EAD group and non-EAD group.Perioperative data of donors and recipients were collected to analyze the risk factors of EAD and the effect of EAD on the short-term prognosis of patients.Results In 45 patients,the incidence of EAD was 57.8％ (26 cases).During the follow-up period,the mortality of recipients in EAD group and non-EAD group was 15.4％ and 15.8％ respectively,which showed no significant difference.Donor age,preoperative ALT and AST levels,cold ischemia time (CIT) were significantly increased in EAD group than in non-EAD group (43.7 ±2.5 and36.2±2.5,P=0.0409;64.2 ±13.2 and 31.0 ± 5.9,P=0.0407;87.3±16.2 and48.2±6.2,P=0.047 3;629.5 ± 35.2 and 484.6 ± 30.5,P =0.004 0,respectively).Perioperative CRP level in EAD group was significantly higher than in non-EAD group (22.6 ± 5.9 and 4.7 ± 1.1,P =0.012 1).What's more,postoperative platelet level was significantly lower in EAD group than in nonEAD group (73.7 ± 8.0 and 111.7 ±16.0,P =0.0439).However,pre-and post-operative neutrophil-lymphocyte ratio (NLR) in recipients showed no significant difference between EAD group and non-EAD groups.Conclusion Older donor age,high levels of preoperative ALT and AST,prolonged cold ischemic time,as well as high level of preoperative CRP and decrease of postoperative platelet level in recipients are risk factors for the occurrence of EAD after liver transplantation.