Microvesicular Liver Graft Steatosis as a Risk Factor of Initial Poor Function in Relation to Suboptimal Donor Parameters

Cieślak, Bartosz; Lewandowski, Zbigniew; Urban, Marian; Ziarkiewicz‐Wróblewska, Bogna; Krawczyk, Marek

doi:10.1016/j.transproceed.2009.08.019

Cited by 38 publications

(27 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Laboratory changes reflecting liver metabolism and function in the first few days after transplantation, such as serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, prothrombin time (PT), international normalized ratio (INR), and serum lactate and ammonia levels, are the most commonly used parameters. (2,(7)(8)(9)(10)(11)(12)(13)(14)(15) Early allograft dysfunction is known to be associated with lower graft and patient survival rates, longer stay at intensive care unit (ICU) and increased postoperative morbidity and mortality. (9) Previous studies taking time to dysfunction diagnosis as the driving factor for implementation of patient support therapy established the third postoperative day as the cut-off time for EAD.…”

Section: Early Allograft Dysfunctionmentioning

confidence: 99%

Primary graft dysfunction of the liver: definitions, diagnostic criteria and risk factors

Neves

Rusi

Díaz

et al. 2016

Einstein (São Paulo)

View full text Add to dashboard Cite

Primary graft dysfunction is a multifactorial syndrome with great impact on liver transplantation outcomes. This review article was based on studies published between January 1980 and June 2015 and retrieved from PubMed database using the following search terms: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" and "liver transplantation". Graft dysfunction describes different grades of graft ischemia-reperfusion injury and can manifest as early allograft dysfunction or primary graft non-function, its most severe form. Donor-, surgery-and recipient-related factors have been associated with this syndrome. Primary graft dysfunction definition, diagnostic criteria and risk factors differ between studies.

show abstract

Section: Early Allograft Dysfunctionmentioning

confidence: 99%

Primary graft dysfunction of the liver: definitions, diagnostic criteria and risk factors

Neves

Rusi

Díaz

et al. 2016

Einstein (São Paulo)

View full text Add to dashboard Cite

show abstract

“…While some authors suggested that livers with severe MiS can be safely used for LT [37], another Noujaim et al Frontiers in Liver Transplantation study reported a 100% primary graft non-function rate when severely steatotic grafts with MiS were used for re-transplantation [38] (Table 3). A recent study showed that MiS per se is an independent donor factor influencing donor graft function [39]. Reports on transplanting livers with P60% of predominantly MaS are scarce.…”

Section: Referencementioning

confidence: 99%

Liver transplantation using fatty livers: Always feasible?

McCormack

Dutkowski²,

El‐Badry³

et al. 2011

Journal of Hepatology

252

236

View full text Add to dashboard Cite

Steatotic liver grafts represent the most common type of "extended criteria" organs that have been introduced during the last two decades due to the disparity between liver transplant candidates and the number available organs. A precise definition and reliable and reproducible method for steatosis quantification is currently lacking and the potential influence of the chemical composition of hepatic lipids has not been addressed. In our view, these shortcomings appear to contribute significantly to the inconsistent results of studies reporting on graft steatosis and the outcome of liver transplantation. In this review, various definitions, prevalence and methods of quantification of liver steatosis will be covered. Ischemia/reperfusion injury of the steatotic liver and its consequences on post-transplant outcome will be discussed. Selection criteria for organ allocation and a number of emerging protective strategies are suggested.

show abstract

“…Nevertheless, a recent study has reported that microvesicular steatosis increased the risk of initial poor graft function (IPF) (OR = 1.38 per 1 SD = 9.3%; P < 0.021) [47] and work is required to establish if it influences HCV recurrence.…”

Section: Donor Graft Steatosismentioning

confidence: 99%

Strategies to reduce hepatitis C virus recurrence after liver transplantation

Ciria

Pleguezuelo²,

Khorsandi³

et al. 2013

WJH

View full text Add to dashboard Cite

Hepatitis C virus (HCV) is a major health problem that leads to chronic hepatitis, cirrhosis and hepatocellular carcinoma, being the most frequent indication for liver transplantation in several countries. Unfortunately, HCV re-infects the liver graft almost invariably following reperfusion, with an accelerated history of recurrence, leading to 10%-30% of patients progressing to cirrhosis within 5 years of transplantation. In this sense, some groups have even advocated for not retransplanting this patients, as lower patient and graft outcomes have been reported. However, the management of HCV recurrence is being optimized and several strategies to reduce post-transplant recurrence could improve outcomes, decrease the rate of re-transplantation and optimize the use of available grafts. Three moments may be the focus of potential actions in order to decrease the impact of viral recurrence: the pretransplant moment, the transplant environment and the post-transplant management. In the pre-transplant setting, it is not well established if reducing the pre transplant viral load affects the risk for HCV progression after transplant. Obviously, antiviral treatment can render the patient HCV RNA negative post transplant but the long-term benefit has not yet been fully established to justify the cost and clinical risk. In the transplant moment, factors as donor age, cold ischemia time, graft steatosis and ischemia/reperfusion injury may lead to a higher and more aggressive viral recurrence. After the transplant, discussion about immunosuppression and the moment to start the treatment (prophylactic, pre-emptive or once-confirmed) together with new antiviral drugs are of interest. This review aims to help clinicians have a global overview of posttransplant HCV recurrence and strategies to reduce its impact on our patients.

show abstract

Microvesicular Liver Graft Steatosis as a Risk Factor of Initial Poor Function in Relation to Suboptimal Donor Parameters

Cited by 38 publications

References 8 publications

Primary graft dysfunction of the liver: definitions, diagnostic criteria and risk factors

Primary graft dysfunction of the liver: definitions, diagnostic criteria and risk factors

Liver transplantation using fatty livers: Always feasible?

Strategies to reduce hepatitis C virus recurrence after liver transplantation

Contact Info

Product

Resources

About