Uma proposta para graduar a gravidade de disfunção precoce do enxerto após o transplante de fígado

Salvalaggio, Paolo R.; Afonso, R.C.; Felga, Guilherme Eduardo Gonçalves; Ferraz-Neto, Ben Hur

doi:10.1590/s1679-45082013000100006

Cited by 26 publications

(6 citation statements)

References 35 publications

(36 reference statements)

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“…To understand the relevance of the two lipids to transplantation we investigated EAD. EAD is a clinical term which can reflect donor, recipient and transplant characteristics, and it can be utilized as a transplant benchmark 39 . The incidence of EAD in our study was 26%, this was in the upper range of known values for incidence ranging from 14% to 27% 40 .…”

Section: Discussionmentioning

confidence: 99%

Lipidomics comparing DCD and DBD liver allografts uncovers lysophospholipids elevated in recipients undergoing early allograft dysfunction

Casas-Ferreira

et al. 2015

Sci Rep

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Finding specific biomarkers of liver damage in clinical evaluations could increase the pool of available organs for transplantation. Lipids are key regulators in cell necrosis and hence this study hypothesised that lipid levels could be altered in organs suffering severe ischemia. Matched pre- and post-transplant biopsies from donation after circulatory death (DCD, n = 36, mean warm ischemia time = 21min) and donation after brain death (DBD, n = 76, warm ischemia time = none) were collected. Lipidomic discovery and multivariate analysis (MVA) were applied. Afterwards, univariate analysis and clinical associations were conducted for selected lipids differentiating between these two groups. MVA grouped DCD vs. DBD (p = 6.20 × 10−12) and 12 phospholipids were selected for intact lipid measurements. Two lysophosphatidylcholines, LysoPC (16:0) and LysoPC (18:0), showed higher levels in DCD at pre-transplantation (q < 0.01). Lysophosphatidylcholines were associated with aspartate aminotransferase (AST) 14-day post-transplantation (q < 0.05) and were more abundant in recipients undergoing early allograft dysfunction (EAD) (p < 0.05). A receiver-operating characteristics (ROC) curve combining both lipid levels predicted EAD with 82% accuracy. These findings suggest that LysoPC (16:0) and LysoPC (18:0) might have a role in signalling liver tissue damage due to warm ischemia before transplantation.

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Section: Discussionmentioning

confidence: 99%

Lipidomics comparing DCD and DBD liver allografts uncovers lysophospholipids elevated in recipients undergoing early allograft dysfunction

Casas-Ferreira

et al. 2015

Sci Rep

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“…The AST peak between 2000 U/L and 3000 U/L presented in the case classifies it as a mild early graft dysfunction [16]. However, in the follow-up, there was no impairment that required emergency intervention or resulted in graft loss.…”

Section: Case Reportmentioning

confidence: 71%

Liver Transplant with a Donor after Bothropic Accident - Case Report

Feitosa¹,

Souza²,

Pinho³

et al. 2019

Int J Transplant Res Med

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Background: Orthotopic Liver transplantation is the primary treatment for most end-stage-liver diseases. Victims of snakebite are potential organ donors since the venom's ability to induce irreversible brain damage. However, in the literature, reports of liver transplants obtained from victims of these accidents, their outcome and follow up are practically non-existent. Our purpose is to report a case of a donor with brain death following complications of a bothropic accident, and the patient who receives the liver with cirrhosis due to Hepatitis B. Case report: A 40-year-old male patient was admitted to Fortaleza General Hospital (HGF) to perform a liver transplant. The 67-year-old donor, who, after a snakebite of the species Bothrops jararaca, developed coagulopathy and progressed with a hemorrhagic stroke. There was confirmation of encephalic death. In the laboratory examinations, the donor presented AST of 17 U/L, ALT of 20 U/L, total bilirubin 2,4 mg/dL and platelets of 80,000/µl. Hepatic transplantation was performed, which occurred without complications. On the first postoperative day (PO), there was an AST peak of 2885 U/L and ALT of 1497 U/L, followed by progressive reduction. In the eighth PO, ultrasonography with Doppler showed a graft without alterations. Conclusion: There were no complications that compromised the graft or the life of the recipient, being, this case, an example of the possibility that the organs from deceased snakebites donors can be transplanted.

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“…Although the majority of EAD patients eventually recover, they are still at risk of longer intensive care unit and hospital stays, [ 20 , 21 ] graft loss, and greater morbidity and mortality. [ 22 ] Recently, a predictive model for EAD after LT was reported [ 2 ] ; nevertheless, a predictive score for EAD after LDLT in the form of a nomogram has not been developed. In this study, we aimed to develop a nomogram examining donor and recipient characteristics in addition to blood biomarkers at different stages of transplantation to predict EAD.…”

Section: Introductionmentioning

confidence: 99%

A nomogram for prediction of early allograft dysfunction in living donor liver transplantation

Tsai

Lee

et al. 2020

Medicine

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Liver transplantation is the treatment of choice for end-stage liver diseases. However, early allograft dysfunction (EAD) is frequently encountered and associated with graft loss or mortality after transplantation. This study aimed to establish a predictive model of EAD after living donor liver transplantation. A total of 77 liver transplants were recruited to the study. Multivariate analysis was utilized to identify significant risk factors for EAD. A nomogram was constructed according to the contributions of the risk factors. The predictive values were determined by discrimination and calibration methods. A cohort of 30 patients was recruited to validate this predictive model. Four independent risk factors, including donor age, intraoperative blood loss, preoperative alanine aminotransferase (ALT), and reperfusion total bilirubin, were identified and used to build the nomogram. The c-statistics of the primary cohort and the validation group were 0.846 and 0.767, respectively. The calibration curves for the probability of EAD presented an acceptable agreement between the prediction by the nomogram and the actual incidence. In conclusion, the study developed a new nomogram for predicting the risk of EAD following living donor liver transplantation. This model may help clinicians to determine individual risk of EAD following living donor liver transplantation.

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Uma proposta para graduar a gravidade de disfunção precoce do enxerto após o transplante de fígado

Cited by 26 publications

References 35 publications

Lipidomics comparing DCD and DBD liver allografts uncovers lysophospholipids elevated in recipients undergoing early allograft dysfunction

Lipidomics comparing DCD and DBD liver allografts uncovers lysophospholipids elevated in recipients undergoing early allograft dysfunction

Liver Transplant with a Donor after Bothropic Accident - Case Report

A nomogram for prediction of early allograft dysfunction in living donor liver transplantation

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