Liver transplantationAnalysis of initial poor graft function after orthotopic liver transplantation: experience of an australian single liver transplantation center
Section snippets
Patients
The study group consisted of 93 adult patients with end-stage liver disease who underwent OLTx in the Australian National Liver Transplantation Unit of Royal Prince Alfred Hospital between January 1998 and September 2000. There were 66 males and 27 females with a mean age of 47 ± 13 years (range, 17 to 67 years). For the purpose of the study, IPGF was defined as an increased level of AST and/or ALT of greater than 1500 IU/L on two consecutive measurements within the first 72 hours after OLTx in
Results
The donor and recipient demographics are shown in Table 1. Although more allografts had significant steatosis in the IPGF group compared to the control group, this was not statistically significant. There were no patients with either primary biliary cirrhosis or primary sclerosing cholangitis in the IPGF group compared to the control group. However, there were more patients with alcoholic cirrhosis in the IPGF versus control groups. There was a trend for recipients in the IPGF group to have a
Discussion
The definition of IPGF is variable within the literature (Table 5). Maring et al3 compared the patient outcome by the criteria set out by Ploeg et al4 and Gonzalez et al.13 Patients with poor graft function defined by Pleog’s criteria showed higher morbidity and mortality compared to those with a well-functioning graft. However, the prediction of IPGF was still difficult in Maring’s series.3 In our institution, AST and/or ALT levels were established at lower levels (> 1500 IU/L) within the
Acknowledgements
We acknowledge all specialist physicians, surgeons, and paramedical staff involved in patient care at the Australian National Liver Transplantation Unit of Royal Prince Alfred Hospital. We thank Ms Jodie Fisher for her assistance with data collection and analysis and Mrs Nutan Verma for typing of the manuscript.
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