alexa Validation of a current definition of early allograft dysfunction in liver transplant recipients and analysis of risk factors.


Journal of Gastrointestinal & Digestive System

Author(s): Olthoff KM, Kulik L, Samstein B, Kaminski M, Abecassis M,

Abstract Share this page

Abstract Translational studies in liver transplantation often require an endpoint of graft function or dysfunction beyond graft loss. Prior definitions of early allograft dysfunction (EAD) vary, and none have been validated in a large multicenter population in the Model for End-Stage Liver Disease (MELD) era. We examined an updated definition of EAD to validate previously used criteria, and correlated this definition with graft and patient outcome. We performed a cohort study of 300 deceased donor liver transplants at 3 U.S. programs. EAD was defined as the presence of one or more of the following previously defined postoperative laboratory analyses reflective of liver injury and function: bilirubin >or=10mg/dL on day 7, international normalized ratio >or=1.6 on day 7, and alanine or aspartate aminotransferases >2000 IU/L within the first 7 days. To assess predictive validity, the EAD definition was tested for association with graft and patient survival. Risk factors for EAD were assessed using multivariable logistic regression. Overall incidence of EAD was 23.2\%. Most grafts met the definition with increased bilirubin at day 7 or high levels of aminotransferases. Of recipients meeting the EAD definition, 18.8\% died, as opposed to 1.8\% of recipients without EAD (relative risk = 10.7 [95\% confidence interval: 3.6, 31.9] P < 0.0001). More recipients with EAD lost their grafts (26.1\%) than recipients with no EAD (3.5\%) (relative risk = 7.4 [95\% confidence interval: 3.4, 16.3] P < 0.0001). Donor age and MELD score were significant EAD risk factors in a multivariate model. In summary a simple definition of EAD using objective posttransplant criteria identified a 23\% incidence, and was highly associated with graft loss and patient mortality, validating previously published criteria. This definition can be used as an endpoint in translational studies aiming to identify mechanistic pathways leading to a subgroup of liver grafts with clinical expression of suboptimal function. TRIAL REGISTRATION: NCT00531921. (c) 2010 AASLD. This article was published in Liver Transpl and referenced in Journal of Gastrointestinal & Digestive System

Relevant Expert PPTs

Relevant Speaker PPTs

  • Ofir Menashe
    The use of constructed nano and micro-filtration membrane as a confine bioreactor for microbial growth and extracellular digestive enzymes secretion
    PPT Version | PDF Version

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version