TY - JOUR
T1 - Application of ischaemia-free liver transplantation improves prognosis of patients with steatotic donor livers – a retrospective study
AU - Chen, Maogen
AU - Chen, Zhitao
AU - Lin, Xiaohong
AU - Hong, Xitao
AU - Ma, Yihao
AU - Huang, Changjun
AU - He, Xiaoshun
AU - Ju, Weiqiang
N1 - Funding Information:
This work was supported by the National Natural Science Foundation of China (81401324 and 81770410), the Science and Technology Planning Project of Guangdong Province (2016A020215048), the Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology (2013A061401007), the Guangdong Basic and Applied Basic Research Foundation (2020A1515011557, 2020A1515010903) and the Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation) (2015B050501002), China.
Publisher Copyright:
© 2021 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.
PY - 2021/7
Y1 - 2021/7
N2 - The use of steatotic livers in liver transplantation (LT) is controversial. Ischaemia-free liver transplantation (IFLT) has obvious advantages for the recovery of allograft function. The aim of this study was to examine the effect of liver grafts with steatosis on outcome and the effect of IFLT with steatotic livers. 360 patients with LT were enrolled in this study. Perioperative characteristics and differences in outcome among different grades of steatotic groups, and between the IFLT and conventional LT (CLT) groups were analysed. Occurrence of early allograft dysfunction (EAD; 50%) and primary nonfunction (PNF; 20%) was significantly higher in the severe steatosis group (P < 0.001 and <0.001, respectively). Survival rate is significantly low in severe steatosis group (3-year: 60%, P = 0.0039). The IFLT group had a significantly lower occurrence of EAD than the CLT group (0% vs. 60%, P = 0.01). The level of postoperative peak AST, GGT and creatine were significantly lower in IFLT group (P = 0.009, 0.032 and 0.024, respectively). In multivariable analysis, IFLT and EAD were independent factors affecting postoperative survival. Severe steatotic livers lead to severe complications and poor outcomes in LT. IFLT has obvious advantages for reducing the rate of EAD in LT with steatotic livers.
AB - The use of steatotic livers in liver transplantation (LT) is controversial. Ischaemia-free liver transplantation (IFLT) has obvious advantages for the recovery of allograft function. The aim of this study was to examine the effect of liver grafts with steatosis on outcome and the effect of IFLT with steatotic livers. 360 patients with LT were enrolled in this study. Perioperative characteristics and differences in outcome among different grades of steatotic groups, and between the IFLT and conventional LT (CLT) groups were analysed. Occurrence of early allograft dysfunction (EAD; 50%) and primary nonfunction (PNF; 20%) was significantly higher in the severe steatosis group (P < 0.001 and <0.001, respectively). Survival rate is significantly low in severe steatosis group (3-year: 60%, P = 0.0039). The IFLT group had a significantly lower occurrence of EAD than the CLT group (0% vs. 60%, P = 0.01). The level of postoperative peak AST, GGT and creatine were significantly lower in IFLT group (P = 0.009, 0.032 and 0.024, respectively). In multivariable analysis, IFLT and EAD were independent factors affecting postoperative survival. Severe steatotic livers lead to severe complications and poor outcomes in LT. IFLT has obvious advantages for reducing the rate of EAD in LT with steatotic livers.
KW - early allograft dysfunction
KW - ischaemia-free liver transplantation
KW - primary nonfunction
KW - steatosis
UR - http://www.scopus.com/inward/record.url?scp=85107388727&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85107388727&partnerID=8YFLogxK
U2 - 10.1111/tri.13828
DO - 10.1111/tri.13828
M3 - Article
C2 - 33484201
AN - SCOPUS:85107388727
VL - 34
SP - 1261
EP - 1270
JO - Transplant International
JF - Transplant International
SN - 0934-0874
IS - 7
ER -