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المؤلفAnouti, Ahmad
المؤلفAl Hariri, Moustafa
المؤلفVanWagner, Lisa B.
المؤلفLee, William M.
المؤلفMufti, Arjmand
المؤلفPedersen, Mark
المؤلفShah, Jigesh
المؤلفHanish, Steven
المؤلفVagefi, Parsia A.
المؤلفCotter, Thomas G.
المؤلفPatel, Madhukar S.
تاريخ الإتاحة2024-05-09T09:56:14Z
تاريخ النشر2024-02-21
اسم المنشورDigestive Diseases and Sciences
المعرّفhttp://dx.doi.org/10.1007/s10620-024-08280-5
الاقتباسAnouti, A., Al Hariri, M., VanWagner, L. B., Lee, W. M., Mufti, A., Pedersen, M., ... & Patel, M. S. (2024). Early Graft Failure After Living-Donor Liver Transplant. Digestive Diseases and Sciences, 1-8.
الرقم المعياري الدولي للكتاب0163-2116
معرّف المصادر الموحدhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85185499444&origin=inward
معرّف المصادر الموحدhttp://hdl.handle.net/10576/54791
الملخصBackground: Living-donor liver transplantation (LDLT) has been increasing in the USA. While data exist on longer-term patient and graft outcomes, a contemporary analysis of short-term outcomes is needed. Aim: Evaluate short-term (30-day) graft failure rates and identify predictors associated with these outcomes. Methods: Adult (≥ 18) LDLT recipients from 01/2004 to 12/2021 were analyzed from the United States Scientific Registry of Transplant Recipients. Graft status at 30 days was assessed with graft failure defined as retransplantation or death. Comparison of continuous and categorical variables was performed and a multivariable logistic regression was used to identify risk factors of early graft failure. Results: During the study period, 4544 LDLTs were performed with a graft failure rate of 3.4% (155) at 30 days. Grafts from male donors (aOR: 0.63, CI 0.44–0.89), right lobe grafts (aOR: 0.40, CI 0.27–0.61), recipients aged > 60 years (aOR: 0.52, CI 0.32–0.86), and higher recipient albumin (aOR: 0.73, CI 0.57–0.93) were associated with superior early graft outcomes, whereas Asian recipient race (vs. White; aOR: 3.75, CI 1.98–7.10) and a history of recipient PVT (aOR: 2.7, CI 1.52–4.78) were associated with inferior outcomes. LDLTs performed during the most recent 2016–2021 period (compared to 2004–2009 and 2010–2015) resulted in significantly superior outcomes (aOR: 0.45, p < 0.001). Conclusion: Our study demonstrates that while short-term adult LDLT graft failure is uncommon, there are opportunities for optimizing outcomes by prioritizing right lobe donation, improving candidate nutritional status, and careful pre-transplant risk assessment of candidates with known PVT. Notably, a period effect exists whereby increased LDLT experience in the most recent era correlated with improved outcomes. Graphical Abstract: (Figure presented.).
راعي المشروعThis work is supported by the Dedman Scholar of Clinical Care at UT Southwestern Medical center. It is also supported by the American Association for the Study of Liver Diseases (AASLD) Clinical, Translational and Outcomes Research Award (CTORA) and National Institute for Alcohol Abuse and Alcoholism (NIAAA) K23AA031310 grant. It is also supported by U01 DK58369 and by research support from Intercept, Aurora, Gilead, Novo Nordisk, Alexion, Eiger, Camurus and Lipocine and consults for Forma, SeaGen, GSK, Karuna, and Cortexyme. This research is also supported by NIH grant R56 HL155093 and by research support from W.L. Gore & Associates and the American Society for Transplantation, consults for Gerson Lehrman Group and Numares.
اللغةen
الناشرSpringer Nature
الموضوعGraft failure
Liver transplant (LT)
Living-donor liver transplant (LDLT)
Portal vein thrombosis (PVT)
ReTransplantation
العنوانEarly Graft Failure After Living-Donor Liver Transplant
النوعArticle
الصفحات1-8
رقم العدد4
رقم المجلد69
ESSN1573-2568
dc.accessType Full Text


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