Ann Surg Treat Res.  2023 Sep;105(3):141-147. 10.4174/astr.2023.105.3.141.

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

• Lee N
• Cha S
• Kim J
• Lee Y
• Kang E
• Kim HJ
• Hong SH
• Rhu J
• Choi GS
• Joh JW

• KMID: 2545905
• DOI: http://doi.org/10.4174/astr.2023.105.3.141

Abstract

Purpose
Deceased donor liver transplantation (DDLT) recipients in Korea are generally sicker due to an increasing organ shortage. In the present study, the risk factors for early 30-day liver graft failure after DDLT were identified.
Methods
From August 2017 to February 2021, 265 adult DDLTs were performed. The characteristics of patients with and without 30-day graft failure were compared.
Results
Liver graft failure occurred in 11 patients (17.7%) after DDLT. Baseline and perioperative characteristics of donors and recipients were not statistically significantly different between the 2 groups. The cumulative graft and overall survival rates at 6 months were 83.9% and 88.7%, respectively. Multivariate analysis showed ventilator support in the pretransplant period was a predisposing factor for 30-day graft failure after DDLT.
Conclusion
Present study indicates that cautious decision is required when allocating DDLT in critically ill patients on mechanical ventilatory support.

Keyword

Brain death donor; Delayed graft function; Liver regeneration; Mechanical ventilator; Primary graft dysfunction

Figure

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  Fig. 1 Median shore durometer values in patients with and without 30-day graft failure. SU, shore unit.

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  Fig. 2 Cumulative survival analysis of deceased donor liver transplantation (DDLT). (A) Graft survival and (B) overall survival.

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