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Ischemia-reperfusion injury and its relationship with early allograft dysfunction in liver transplant patients.
Ito, Takahiro; Naini, Bita V; Markovic, Daniela; Aziz, Antony; Younan, Stephanie; Lu, Michelle; Hirao, Hirofumi; Kadono, Kentaro; Kojima, Hidenobu; DiNorcia, Joseph; Agopian, Vatche G; Yersiz, Hasan; Farmer, Douglas G; Busuttil, Ronald W; Kupiec-Weglinski, Jerzy W; Kaldas, Fady M.
Afiliación
  • Ito T; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Naini BV; Department of Pathology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Markovic D; Department of Medicine Statistics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Aziz A; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Younan S; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Lu M; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Hirao H; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Kadono K; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Kojima H; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • DiNorcia J; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Agopian VG; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Yersiz H; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Farmer DG; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Busuttil RW; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Kupiec-Weglinski JW; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Kaldas FM; The Dumont-UCLA Liver Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Am J Transplant ; 21(2): 614-625, 2021 02.
Article en En | MEDLINE | ID: mdl-32713098
Ischemia-reperfusion injury (IRI) is believed to contribute to graft dysfunction after liver transplantation (LT). However, studies on IRI and the impact of early allograft dysfunction (EAD) in IRI grafts are limited. Histological IRI was graded in 506 grafts from patients who had undergone LT and classified based on IRI severity (no, minimal, mild, moderate, and severe). Of the 506 grafts, 87.4% had IRI (no: 12.6%, minimal: 38.1%, mild: 35.4%, moderate: 13.0%, and severe: 0.8%). IRI severity correlated with the incidence of EAD and graft survival at 6 months. Longer cold/warm ischemia time, recipient/donor hypertension, and having a male donor were identified as independent risk factors for moderate to severe IRI. Among 70 grafts with moderate to severe IRI, 42.9% of grafts developed EAD, and grafts with EAD had significantly inferior survival compared to grafts without EAD. Longer cold ischemia time and large droplet macrovesicular steatosis (≥20%) were identified as independent risk factors for EAD. Our study demonstrated that increased IRI severity was correlated with inferior short-term graft outcomes. Careful consideration of IRI risk factors during donor-recipient matching may assist in optimizing graft utilization and LT outcomes. Furthermore, identification of risk factors of IRI-associated EAD may guide patient management and possible timely graft replacement.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Daño por Reperfusión / Trasplante de Hígado Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans / Male Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Daño por Reperfusión / Trasplante de Hígado Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans / Male Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos