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How To Identify Early Graft Dysfunction Preoperatively

Date:
October 16, 2009
Source:
World Journal of Gastroenterology
Summary:
A research team from Italy described a condition that they define as early graft dysfunction (EGD) which can be identified preoperatively. They found EGD is associated with increased morbidity after living-related liver transplantation.
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Small-for-size graft dysfunction (SFSGD) following living-related liver transplantation (LRLT) is characterized by early graft dysfunction (EGD) when the graft-to-recipient body weight ratio (GRBWR) is below 0.8%. However, patients transplanted with GRBWR above 0.8% can develop dysfunction of the graft.

A research team, led by Dr. Salvatore Gruttadauria from University of Pittsburgh analyzed a group of LRLT recipients in order to identify those who developed a clinical picture of SFSGD in the absence of a GBWR of < 0.8% and with a ratio of graft volume (GV) relative to the standard liver volume (SLV) of the recipient (GV/SLV) highest than 30%. Those patients were defined as affected by early graft dysfunction (EGD).

Their study will be published on September 28, 2009 in the World Journal of Gastroenterology.

In this study, a trend in favor of the non-EGD group (3-mo actuarial survival 98% vs 88%, P = 0.09; 3-mo graft mortality 4.7% vs 20%, P = 0.07) was observed as well as shorter length of stay (LOS) (13 d vs 41.5 d; P = 0.001) and smaller requirement of peri-operative Units of Plasma (4 vs 14; P = 0.036). Univariate analysis of pre-transplant variables identified platelet count, serum bilirubin, INR and Meld-Na score as predictors of EGD. In the multivariate analysis transplant Meld-Na score (P = 0.025, OR: 1.175) and pre-transplant platelet count (P = 0.043, OR: 0.956) were independently associated with EGD.

They drew a conclusion that a prompt recognition of EGD can trigger a timely and appropriate treatment.


Story Source:

Materials provided by World Journal of Gastroenterology. Note: Content may be edited for style and length.


Journal Reference:

  1. Gruttadauria S, di Francesco F, Vizzini GB, Luca A, Spada M, Cintorino D, Li Petri S, Pietrosi G, Pagano D, Gridelli B. Early graft dysfunction following adult-to-adult living-related liver transplantation: Predictive factors and outcomes. World Journal of Gastroenterology, 2009; 15 (36): 4556 DOI: 10.3748/wjg.15.4556

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World Journal of Gastroenterology. "How To Identify Early Graft Dysfunction Preoperatively." ScienceDaily. ScienceDaily, 16 October 2009. <www.sciencedaily.com/releases/2009/10/091016093923.htm>.
World Journal of Gastroenterology. (2009, October 16). How To Identify Early Graft Dysfunction Preoperatively. ScienceDaily. Retrieved July 25, 2024 from www.sciencedaily.com/releases/2009/10/091016093923.htm
World Journal of Gastroenterology. "How To Identify Early Graft Dysfunction Preoperatively." ScienceDaily. www.sciencedaily.com/releases/2009/10/091016093923.htm (accessed July 25, 2024).

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