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How to identify early graft dysfunction preoperatively?
October 16, 2009Small-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.
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.
World Journal of Gastroenterology
Primary graft dysfunction is risk factor for a later serious lung transplant problem
Primary graft dysfunction, a common complication that affects up to 25 percent of lung transplant patients shortly after surgery, constitutes a significant risk factor for later deadly bronchiolotis obliterans syndrome (BOS).
Common cold virus leads to death in lung transplant patients
Human rhinovirus (HRV), the leading cause of most common colds, struck two immunosuppressed lung transplant patients, leading to progressive respiratory failure, graft dysfunction and death.
More Graft Dysfunction Current Events and Graft Dysfunction News Articles
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Primary graft dysfunction redefined by infiltrates, oxygen ratio.(Pulmonary Medicine): An article from: Internal Medicine News by Mitchel L. Zoler (Author) This digital document is an article from Internal Medicine News, published by Thomson Gale on June 1, 2005. The length of the article is 682 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser. Citation Details Title: Primary graft dysfunction redefined by infiltrates, oxygen ratio.(Pulmonary Medicine) Author: Mitchel L. Zoler Publication: Internal Medicine News (Magazine/Journal) Date: June 1, 2005 Publisher: Thomson Gale Volume: 38 Issue: 11 Page: 24(1) Distributed by Thomson... | |
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Liver Transplantation - Official Journal of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society by John Fung (Editor), Jorge Rakela (Editor) Includes articles on: Use of Anticoagulant Therapy Among Patients Awaiting Liver Transplantation; Bone Marrow Transplantation From Donor Immune To HBV May Confer Specific Immunity To HBV (Adoptive Immunity) To A HBV Infected Recipient and Clear HBV Infection; HLA Mismatching As A Risk Factor For PBC Recurrence; Comparison Of Outcomes In HCV Infected Recipients Of LDLT Vesus DDLT; Risk Factors Associated With New Onset Diabetes Mellitus (NODM) After Liver Transplantation |
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