DonationMicrovesicular Liver Graft Steatosis as a Risk Factor of Initial Poor Function in Relation to Suboptimal Donor Parameters
Section snippets
Materials and Methods
Among 269 cases of OLT performed between 2004 and 2006, we excluded retransplantations and multiorgan transplantations. The donor parameters taken into account included: age, body mass index (BMI), intensive care unit (ICU) stay, arterial hypotension, cardiac arrest, sodium concentration, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transpeptidase (GGT), bilirubin concentration, activated partial thromboplastin time (APTT), international normalized ratio
Results
The risk of IPF at day 7 posttransplantation was significantly related to hepatic microvesicular steatosis (OR = 1.38 per 1 SD = 9.3%; P < .021). Accounting for the influence of the other donor factors produced little change in the numerical values of relative risk: from 1.22 (following exclusion of GGT) to 1.46 (after elimination of the influence of bilirubin concentration). A 50% increased risk of IPF was equivalent to 12% of the extent of steatosis. As shown in the Fig 1, an increasing risk
Discussion
Hepatic steatosis is frequently encountered in the European population, a prevalence of 20% to 30% of adults.5, 6 The frequency of this condition among the Polish population is regarded to be similar to the European average, although a frequency has been cited of as much as 50% of persons with steatosis.7 Steatosis of considerable degree is regarded as evidence of ischemia/reperfusion injury; consequently, it is a hepatic dysfunction factor equivalent to IPF and primary nonfunction (PNF). It
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