Analysis of initial poor graft function after orthotopic liver transplantation: experience of an australian single liver transplantation center

IN ORTHOTOPIC LIVER transplantation (OLTx), initial poor graft function (IPGF) may be related to the quality of the donor organ, long cold and warm ischemic times, the medical status of the recipient, the surgical technique used, reduced size liver grafts. With IPGF, subsequent patient morbidity and mortality is increased. Primary graft nonfunction (PNF) is the most serious end result of initial poor allograft function and may occur in 1.4% to 8.5% of cases after OLTx and may require urgent re-transplantation to avoid patient mortality. Despite developments in preservation solutions, operative procedures, and new immunosuppressive agents, IPGF continues to be a major complication immediately after OLTx. The definition and criteria used to diagnose IPGF following OLTx is inconsistent in the literature. Evaluation of early graft dysfunction determined by a high level of transaminases [aspartate aminotransferase (AST) or alanine aminotransferase (ALT)] and coagulation activity are often used as appropriate criteria within 7 days after OLTx.) The present study was undertaken as a retrospective analysis of donor and recipient demographics and intraand postoperative biochemical and pathological features to determine the factors leading to IPGF at a single transplant center in Sydney, Australia.