Korean J Transplant.  2022 Nov;36(Supple 1):S139. 10.4285/ATW2022.F-2604.

Ventilator support in pretransplant predisposes early graft failure after deceased donor liver transplantation

• Cha S
• Hong SH
• Lee Y
• Kang EJ
• Kim HJ
• Rhu J
• Choi GS
• Kim J

• KMID: 2535655
• DOI: http://doi.org/10.4285/ATW2022.F-2604

Abstract

Background
Graft failure is one of the most serious complications that can lead the patient to death after liver transplantation. The aim of this study is to find factors affecting early graft failure in patients who received deceased donor liver transplantation (DDLT).
Methods
This single center retrospective study included a consecutive series of 64 patients undergoing DDLT from August 2017 to February 2021. Graft failure that occurred within 30 days postoperatively was analyzed using binary logistic regression analysis.
Results
Sixty-four patients identified in study period. The incidence of early graft failure was 17.7% (n=11). Among them, three patients underwent retransplantation. The proportion of hepatic encephalopathy grade 3 or 4, the presence of continuous renal replacement therapy due to hepatorenal syndrome, ventilator care support in intensive care unit before transplantation were higher in the early graft failure group than in the no early graft failure group. However, difference in those factors did not reach significant level. Only preoperative ventilator care (odds ratio, 7.750; 95% confidence interval, 1.148–52.297; P=0.036) in inten-sive care unit is a strong predictive factor for early graft failure after DDLT in multivariate analysis.
Conclusions
A pretransplant factor predicting 30-day graft failure in DDLT is patients who received ventilator care before trans-plantation. Present study suggests that patients on the DDLT waiting list receiving ventilator support should be carefully determined DDLT. DDLT should be determined after withdrawal of ventilatory support through sufficient lung care.