DonationMicrovesicular Liver Graft Steatosis as a Risk Factor of Initial Poor Function in Relation to Suboptimal Donor Parameters
Section snippets
Materials and Methods
Among 269 cases of OLT performed between 2004 and 2006, we excluded retransplantations and multiorgan transplantations. The donor parameters taken into account included: age, body mass index (BMI), intensive care unit (ICU) stay, arterial hypotension, cardiac arrest, sodium concentration, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transpeptidase (GGT), bilirubin concentration, activated partial thromboplastin time (APTT), international normalized ratio
Results
The risk of IPF at day 7 posttransplantation was significantly related to hepatic microvesicular steatosis (OR = 1.38 per 1 SD = 9.3%; P < .021). Accounting for the influence of the other donor factors produced little change in the numerical values of relative risk: from 1.22 (following exclusion of GGT) to 1.46 (after elimination of the influence of bilirubin concentration). A 50% increased risk of IPF was equivalent to 12% of the extent of steatosis. As shown in the Fig 1, an increasing risk
Discussion
Hepatic steatosis is frequently encountered in the European population, a prevalence of 20% to 30% of adults.5, 6 The frequency of this condition among the Polish population is regarded to be similar to the European average, although a frequency has been cited of as much as 50% of persons with steatosis.7 Steatosis of considerable degree is regarded as evidence of ischemia/reperfusion injury; consequently, it is a hepatic dysfunction factor equivalent to IPF and primary nonfunction (PNF). It
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Early predictors of prolonged intensive care utilization following liver transplantation
2023, American Journal of SurgeryRisk factors of early liver dysfunction after liver transplantation using grafts from donation after citizen death donors
2022, Transplant ImmunologyCitation Excerpt :Therefore, hepatic steatosis is equivalent to a risk factor for hepatic isolated portal fibrosis (IPF) and PNF. A study revealed that hepatocyte steatosis significantly impacted early graft function recovery, and the degree of steatosis was positively correlated with the risk of IPF [26]. In this study, there was no significant correlation between the length of hospital stay, rejection, and biliary complications of recipients after DCD liver transplantation and the occurrence of postoperative EAD (P > 0.05).
NRF2 assessment in discarded liver allografts: A role in allograft function and salvage
2022, American Journal of TransplantationCitation Excerpt :In addition, histological analysis showed that steatosis was significantly higher in low NRF2 livers and this finding parallels the widely reported interplay of the NRF2 axis in hepatosteatosis and the spectrum of NAFLD.33–35 While the contribution of small droplet macrosteatosis to overall allograft function remains debatable,36–38 its presence can influence mitochondrial beta-oxidation and overall hepatotoxicity.39 Hence, in the clinical setting, hepatic NRF2 expression appears to associate with more favourable inflammatory, metabolic and functional parameters and could therefore be viewed as an important biomarker to help identify allografts salvageable for transplantation.
Early 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.
Post-Operative Care After Liver Transplantation
2020, Pediatric Liver TransplantationRisk factors, surgical complications and graft survival in liver transplant recipients with early allograft dysfunction
2019, Hepatobiliary and Pancreatic Diseases InternationalCitation Excerpt :This classification certainly allows a reproducible assessment method for BMI stratification in future EAD studies. Some authors have also studied the association of graft steatosis with EAD [27,35,36]. Recently, an extensive retrospective from the Mayo clinic found that graft steatosis (>30% on a wedge biopsy 1-h after reperfusion) was an important risk factor for EAD [37].