Liver transplantationOutcome of Liver Transplantation Based on Donor Graft Quality and Recipient Status
Section snippets
Materials and Methods
From January 2003 to September 2009, 260 whole-liver transplantation procedures were performed at our center. The study groups were established according to donor graft quality and recipient status. Based on our previous study,9 donors had a marginal score of 1 if any of the following were present: age older than 60 years, body mass index greater than 27, intensive care unit stay longer than 3 days, high inotropic support including dopamine dose more than 10 μg/kg/min or need for combined
Results
There were 102 patients in group G/G (39%), 75 in group B/G (29%), 46 in group G/B (17.7%), and 37 in group B/B (14%). Recipient age, sex, cold and warm ischemia times, operating time, and indication for OLT were comparable in the studied groups (data not shown). There was no significant difference in cumulative patient and graft survival rates. Respective 1-, 3-, and 5-year patient survival rates were 93%, 86%, and 83% in group G/G; 84%, 79%, and 75.5% in group B/G; 82%, 79%, and 72% in group
Discussion
In the last 15 years, a substantial source of cadaver grafts has been marginal donors including those with obesity, high serum sodium concentration, increased transaminase concentrations, hemodynamic instability, or needing inotropic support.1, 2, 3 Because of our strict exclusion criteria for donors, our OLT results have been good. However, an increasing number of patients are awaiting liver transplantation. Similar to other studies,4, 5 we did not observe worse outcomes of OLT using marginal
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Cited by (31)
Early predictors of prolonged intensive care utilization following liver transplantation
2023, American Journal of SurgeryEarly graft dysfunction after liver transplant: Comparison of different diagnostic criteria in a single-center prospective cohort
2020, Medicina IntensivaCitation Excerpt :Moreover, some criteria also include less common parameters, such as the rate of elimination of molecules cleared by the liver (e.g., indocyanine green or C-Methacetin).11–13 Different classifications define diverse grades of dysfunction (some as dichotomous,12,14–25 some as progressively graded4,26–30 and finally a few as a numeric value31–33) based on different intervals of these parameters. In a search of the literature using PubMed regarding liver allograft dysfunction criteria, we retrieved 38 definitions since 1985, most of them including some but not all of the aforementioned parameters, besides the presence of overt clinical evidence of primary non-function.
The histological assessment of liver fibrosis in grafts from extended criteria donors predicts the outcome after liver transplantation: A retrospective study
2020, Digestive and Liver DiseaseCitation Excerpt :Despite improvement in pre-allocation clinical imaging early allograft dysfunction (EAD) and primary non-function (PNF) still represent a major concern in LT [16–18]. EAD implies a 10.7-fold risk of dying and a 7.4-fold risk of losing the graft [17], whereas PNF may occur in up to 10% of LT from ECD, even in centers where liver biopsies with MS assessment are performed [19]. The aim of the present study is to identify morphological features of liver graft, other than MS, that may affect short- and long-term recipient’s outcome.
Results of Expanded-Criteria Donor Kidneys: A Single-Center Experience in Hungary
2015, Transplantation ProceedingsCitation Excerpt :Despite the lower allograft survival, recipients of ECD kidneys still have an improved patient survival compared with dialysis-treated patients [10]. The decision of allocating an ECD graft to a suitable recipient is controversial, not just in the case of kidney, but other solid-organ transplants too [11]. According to multi-center results, ECD kidneys should be allocated to recipients older than 60 years of age, to diabetic patients older than 40 years, to candidates with failure of vascular access, and to candidates whose expected waiting time, on the waiting list exceeds their life expectancy without a transplant [2].
Primary graft dysfunction after liver transplantation
2014, Hepatobiliary and Pancreatic Diseases InternationalPredictive factors of sustained virological response for recurrent hepatitis C virus after liver transplantation: The Hungarian experience
2012, Transplantation ProceedingsCitation Excerpt :Genotype 1b is known to be a strong negative factor for SVR; the Hungarian population is homogeneous in this respect.4,5 A high viral load in the early postoperative period was associated with a rapid RNA decrease to week 12 in the SVR group (Table 1), which was consistent with the findings of Schmidt et al.6 The use of marginal grafts increased the rate of HCV recurrence and decreased the SVR rate, as we had published previously.7 Donor IL28B rs12979860 CC versus CT/TT genotypes have been associated with early viral response and SVR by Lange et al.8 HCV-core protein modifies the insulin signal,9 and consequently de novo diabetes has been associated with higher fibrosis and Knodell scores after AVT.10