Objective: To evaluate the short-term and long-term impact of early allograft dysfunction (EAD) on graft and patient outcomes after liver transplantation.

Background: EAD is one early complication of liver transplantation. It is not clarified to what extent and how long EAD affects the patient and graft outcomes after liver transplantation.

Methods: A systematic literature search for comparative studies concerning EAD versus non EAD for post-transplant outcomes was conducted in PubMed, Web of Science, Embase and Google Scholar database.

Results: Twenty-two studies involving 10048 subjects were eligible. EAD had a strong effect on the 6-month graft failure (OR=5.20, 95% CI=4.01-6.73) and recipient mortality (OR=5.76, 95% CI=4.28-7.75). There was moderate association between EAD and outcomes at 1 year (graft failure: OR=2.86, 95% CI=2.43-3.36; mortality: OR=2.54, 95% CI=2.13-3.04) and 5 years (graft failure: OR=1.98, 95% CI=1.67-2.35; mortality: OR=1.74, 95% CI=1.45-2.08) EAD was associated with longer stay in both hospital (mean difference=3.81, 95% CI=2.40-5.22) and intensive care unit (mean difference=3.14, 95% CI=2.09-4.19). Patients with EAD had higher risks of post-operative complications, including primary non-function (OR=9.72, 95% CI=5.86-16.13), retransplantation (OR=2.59, 95% CI=1.89-3.55), infection (OR=1.49, 95% CI=1.11-2.00), acute steroid-resistant rejection (OR=1.59, 95% CI=1.11-2.29) and renal insufficiency which requires hemodialysis (OR=2.29, 95% CI=1.80-2.93).

Conclusions: EAD has long-lasting deleterious impact on post-transplant graft and recipient outcomes after liver transplantation. Efforts should be made to prevent and treat EAD to improve graft and patient survival.

CITATION INFORMATION: Guo Z, Zheng D, He X, Chen G. Impact of Early Allograft Dysfunction on Graft and Patient Outcomes After Liver Transplantation. Am J Transplant. 2017;17 (suppl 3).

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