Preharvest donor hyperoxia predicts good early graft function and longer graft survival after liver transplantation
Open Access
- 21 January 2005
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Liver Transplantation
- Vol. 11 (2), 140-151
- https://doi.org/10.1002/lt.20339
Abstract
A total of 44 donor/recipient perioperative and intraoperative variables were prospectively analyzed in 89 deceased-donor liver transplantations classified as initial good graft function (IGGF) or initial poor graft function (IPGF) according to a scoring system based on values obtained during the 1st 72 postoperative hours from the serum alanine aminotransferase (ALT) concentration, bile output, and prothrombin activity. The IGGF compared with the IPGF group showed: 1) longer graft (P = .002) and patient (P = .0004) survival; 2) at univariate analysis, a higher (mean [95% confidence interval]) preharvest donor arterial partial pressure of oxygen (PaO2) (152 [136-168] and 104 [91-118] mmHg, respectively; P = .0008) and arterial hemoglobin oxygen saturation (97.9 [97.2-98.7] and 96.7 [95.4-98.0]%, respectively; P = .0096), a lower percentage of donors older than 65 years (13 and 33%, respectively; P = .024), a lower percentage of donors treated with noradrenaline (16 and 41%, respectively; P = .012). At multivariate analysis, IGGF was associated positively with donor PaO2 and negatively with donor age greater than 65 years and with donor treatment with noradrenaline. Independently from the grouping according to initial graft function, graft survival was longer when donor PaO2 was >150 mmHg than when donor PaO2 was ≤150 mmHg (P = .045). In conclusion, preharvest donor hyperoxia predicts IGGF and longer graft survival. (Liver Transpl 2005;11:140–151.)Keywords
This publication has 39 references indexed in Scilit:
- The utility of marginal donors in liver transplantationLiver Transplantation, 2003
- Evaluation of potential liver donors: Limits imposed by donor variables in liver transplantationLiver Transplantation, 2003
- Analysis of initial poor graft function after orthotopic liver transplantation: experience of an australian single liver transplantation centerTransplantation Proceedings, 2002
- Donor fatty (steatotic) liver allografts in orthotopic liver transplantation: a revisitTransplantation Proceedings, 2000
- Is the use of marginal donors justified in liver transplantation? Analysis of results and proposal of modern criteriaTransplant International, 1996
- Selecting the donor liver: Risk factors for poor function after orthotopic liver transplantationJournal of Hepatology, 1994
- Predictive factors of early postoperative graft function in human liver transplantationJournal of Hepatology, 1994
- RISK FACTORS FOR PRIMARY DYSFUNCTION AFTER LIVER TRANSPLANTATION—A MULTIVARIATE ANALYSISTransplantation, 1993
- THE USE OF mARGINAL DONORS FOR LIVER TRANSPLANTATION A RETROSPECTIVE STUDY OF 365 LIVER DONORS 1,2Transplantation, 1992
- Personal experience with the procurement of 132 liver allograftsTransplant International, 1989