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Chinese Archives of General Surgery(Electronic Edition) ›› 2021, Vol. 15 ›› Issue (03): 161-167. doi: 10.3877/cma.j.issn.1674-0793.2021.03.001

Special Issue:

• Original Article •     Next Articles

Clinical features and outcomes of primary non-function after liver transplantation: A single-center report

Shujiao He1, Shirui Chen1, Tao Luo1, Yunhua Tang1, Zhiyong Guo1,(), Xiaoshun He1   

  1. 1. Organ Transplant Center, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
  • Received:2020-12-08 Online:2021-06-01 Published:2021-06-16
  • Contact: Zhiyong Guo

Abstract:

Objective

To investigate the clinical characteristics and risk factors of primary non-function (PNF) after liver transplantation in the era of volunteer deceased organ donation in our center.

Methods

Clinical data, laboratory parameters and follow-up results of 647 adult liver transplantation patients in the First Affiliated Hospital of Sun Yat-sen University from January 2015 to December 2019 were retrospectively analyzed.

Results

During the study period, PNF occurred in 29 patients (4.48%) post-transplantation. The functional characteristics of PNF patients were liver synthesis and metabolic dysfunction, with alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) rapidly rising, accompanied by severe coagulation dysfunction. Univariate and multivariate analysis showed that preoperative kidney replacement therapy, total duration of operation and donor risk index (DRI) were independent risk factors for PNF, in which DRI>2.24 was the best critical point for predicting PNF (AUC=0.756, P=0.002).

Conclusions

PNF is a rare and serious complication after liver transplantation, and re-transplantation is the only effective treatment. It is found that preoperative kidney replacement therapy, total duration of operation and DRI are independent risk factors for PNF, and DRI>2.24 appears to be a potential predictor of PNF, which may help to discard a donor liver or attempt to use normothermic machine perfusion for organ preservation.

Key words: Primary non-function, Liver transplantation, Clinical characteristics, Risk factors

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