Predictive model and risk factors associated with a revised definition of early allograft dysfunction in liver transplant recipients Article

Full Text via DOI: 10.1111/ctr.13097 PMID: 28856732 Web of Science: 000414345800009

Cited authors

  • Nicolau-Raducu, Ramona; Cohen, Ari J.; Bokhari, Amjad; Bohorquez, Humberto; Bruce, David; Carmody, Ian; Bugeaud, Emily; Seal, John; Sonnier, Dennis; Nossaman, Bobby; Loss, George


  • Introduction: Early allograft dysfunction (EAD) is a well-defined clinical syndrome that reflects overall graft function within the first week after transplant. The aim of this study was to further refine the definition for EAD.; Method: In this study, 1124 patients were included for analysis. Logistic regression was performed to identify markers of liver injury associated with 6-month patient and graft failure.; Results: Recursive partitioning identified cut-points for ALT/AST > 3000/6000 IU/dL observed within first week, with bilirubin 10 mg/dL and INR >= 1.6 on postoperative day 7 for the revised EAD model. The incidence of updated EAD was 15% (164/1124). Multivariable analysis identified eight risk factors associated with EAD: % macrosteatosis, donor location, donor weight, nonheart beating donors, type of organ transplanted, recipient-associated hepatocellular carcinoma, severity of postreperfusion syndrome, and the amount of transfused fresh frozen plasma. In the presence of EAD, the incidence of post-transplant renal replacement therapy and dialysis dependence increases. There was a significant association of the presence of EAD with 6-month mortality (12% vs 3%) and 6-month graft failure (8% vs 1%).; Conclusion: Higher AST/ALT level needed as cutoff in comparison with the old EAD definition.

Publication date

  • 2017

Published in

International Standard Serial Number (ISSN)

  • 0902-0063


  • 31


  • 11