Portal Flow <1000 cc Is Not Associated With Early Graft Dysfunction in Orthotopic Liver Transplantation

M. Gastaca,¹ M. Prieto,¹ A. Matarranz,¹ A. Valdivieso,¹ P. Ruiz,¹ A. Ventoso,¹ I. Palomares,¹ L. Martinez-Indart,² J. Fernandez,³ J. Ortiz de Urbina.¹

¹Hepatobiliary Surgery and Liver Transplantation Unit, Cruces University Hospital. University of the Basque Country, Bilbao, Vizcaya, Spain
²Epidemiology Unit, Cruces University Hospital. University of the Basque Country, Bilbao, Vizcaya, Spain
³Hepatology Unit, Cruces University Hospital. University of the Basque Country, Bilbao, Vizcaya, Spain.

Meeting: 2015 American Transplant Congress

Abstract number: C140

Keywords: Graft failure, Graft survival, Outcome

Session Information

Session Name: Poster Session C: Liver Retransplantation and Other Complications

Session Type: Poster Session

Date: Monday, May 4, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Purpose: The aim of our study was to determine whether a portal flow <1000 cc after orthotopic liver transplantation (OLT) is associated with a higher incidence of early graft dysfunction (EGD).

Methods: A retrospective study was performed with 540 OLTs carried out consecutively from December 2004 to December 2013. Patients were divided into two groups: Group A (portal flow <1000 cc) and group B (portal flow >1000 cc). Portal flow was measured with a transit time ultrasonic flowmeter (Medistim®, Norway). Both groups were compared for multiple variables from the donor, the recipient and the OLT procedure. Comparisons between experimental groups were made by Mann-Whitney U and Chi-square tests for continuous and categorical variables, respectively. EGD was defined by the occurrence of one or more of the following variables: (1) bilirubin ≥10 mg/dL; (2) INR ≥1.6 both on postoperative day 7; (3) aminotransferase level (AST or ALT) >2000 IU/mL within the first 7 postoperative days. We also performed a multivariate logistic regression analysis to determine the risk factors for the development of EGD.

Results: Twenty-nine patients were included in Group A and 511 patients in Group B. Group A was significantly related with lesser weighed donors and recipients, with female recipients of cholestatic disease, with lower MELD score and lesser hepatic artery flow. EGD occurred in 6 patients in Group A (21.4%) vs 109 patients in Group B (21.3%) (P=n.s.). Hospital stay were comparable in both groups. Risk factors for EGD in the multivariate analysis were: MELD >20 (OR=2,47 CI 95% [1,44-4,22], p=0,001), cold ischemia time >6h (OR=1,71 CI 95% [1,06-2,76], p=0,027) and centrolobular necrosis in the postreperfusion liver biopsy (OR=1,04 CI 95% [1,01-1,07], p=0,001).

Conclusions: A portal flow <1000 cc in OLT was more frequently observed in lesser weighted recipients with better liver function and was not related with a higher incidence of EGD. The risk factors for EGD after OLT were MELD >20, cold ischemia time >6h and centrolobular necrosis in the postreperfusion liver biopsy.

To cite this abstract in AMA style:

Gastaca M, Prieto M, Matarranz A, Valdivieso A, Ruiz P, Ventoso A, Palomares I, Martinez-Indart L, Fernandez J, Urbina JOrtizde. Portal Flow <1000 cc Is Not Associated With Early Graft Dysfunction in Orthotopic Liver Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/portal-flow-1000-cc-is-not-associated-with-early-graft-dysfunction-in-orthotopic-liver-transplantation/. Accessed November 21, 2024.

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