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Status: Bibliographieeintrag

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Verfasst von:Lozanovski, Vladimir J. [VerfasserIn]   i
 Khajeh, Elias [VerfasserIn]   i
 Fonouni, Hamidreza [VerfasserIn]   i
 Pfeiffenberger, Jan [VerfasserIn]   i
 Haken, Rebecca von [VerfasserIn]   i
 Brenner, Thorsten [VerfasserIn]   i
 Mieth, Markus [VerfasserIn]   i
 Schirmacher, Peter [VerfasserIn]   i
 Michalski, Christoph [VerfasserIn]   i
 Weiss, Karl Heinz [VerfasserIn]   i
 Büchler, Markus W. [VerfasserIn]   i
 Mehrabi, Arianeb [VerfasserIn]   i
Titel:The impact of major extended donor criteria on graft failure and patient mortality after liver transplantation
Verf.angabe:Vladimir J. Lozanovski, Elias Khajeh, Hamidreza Fonouni, Jan Pfeiffenberger, Rebecca von Haken, Thorsten Brenner, Markus Mieth, Peter Schirmacher, Christoph W. Michalski, Karl Heinz Weiss, Markus W. Büchler, Arianeb Mehrabi
E-Jahr:2018
Jahr:[September 2018]
Umfang:13 S.
Illustrationen:Diagramme
Fussnoten:Gesehen am 16.07.2019
Titel Quelle:Enthalten in: Langenbeck's archives of surgery
Ort Quelle:Berlin : Springer, 1948
Jahr Quelle:2018
Band/Heft Quelle:403(2018), 6, Seite 719-731
ISSN Quelle:1435-2451
Abstract:IntroductionNumerous extended donor criteria (EDC) have been identified in liver transplantation (LT), but different EDC have different impacts on graft and patient survival. This study aimed to identify major EDC (maEDC) that were best able to predict the outcome after LT and to examine the plausibility of an allocation algorithm based on these criteria.MethodsAll consecutive LTs between 12/2006 and 03/2014 were included (n = 611). We analyzed the following EDC: donor age > 65 years, body mass index > 30, malignancy and drug abuse history, intensive care unit stay/ventilation > 7 days, aminotransferases > 3 times normal, serum bilirubin > 3 mg/dL, serum Na+ > 165 mmol/L, positive hepatitis serology, biopsy-proven macrovesicular steatosis (BPS) > 40%, and cold ischemia time (CIT) > 14 h. We analyzed hazard risk ratios of graft failure for each EDC and evaluated primary non-function (PNF). In addition, we analyzed 30-day, 90-day, 1-year, and 3-year graft survival. We established low- and high-risk graft (maEDC 0 vs. ≥ 1) and recipient (labMELD < 20 vs. ≥ 20) groups and compared the post-LT outcomes between these groups.ResultsBPS > 40%, donor age > 65 years, and CIT > 14 h (all p < 0.05) were independent predictors of graft failure and patient mortality and increased PNF, 30-day, 90-day, 1-year, and 3-year graft failure rates. Three-year graft and patient survival decreased in recipients of ≥ 1 maEDC grafts (all p < 0.05) and LT of high-risk grafts into high-risk recipients yielded worse outcomes compared with other groups.ConclusionDonor age > 65 years, BPS > 40%, and CIT > 14 h are major EDC that decrease short and 3-year graft survival, and 3-year patient survival. An allocation algorithm based on maEDC and labMELD is therefore plausible.
DOI:doi:10.1007/s00423-018-1704-z
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1007/s00423-018-1704-z
 DOI: https://doi.org/10.1007/s00423-018-1704-z
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:Cold ischemia time
 Donor age
 Liver transplantation allocation algorithm based on maEDC
 Macrovesicular steatosis
 Major EDC
K10plus-PPN:1669200035
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