Risk Factors Of Early Liver Dysfunction After Organ Donation And Transplantation After Death

Objective:at present,as a complication of liver transplantation,Early ailocardiac dysfunction(EAD)has serious influence on the success rate of liver transplantation and the prognosis of patients,while Donation aftercardiac death(DCD)has become the main source of liver Donation.Based on the analysis and summary of risk factors of EAD after DCD liver transplantation,this study evaluated and effectively predicted the occurrence of EAD after DCD liver transplantation,so as to provide references for the clinical treatment and prevention of EAD after DCD liver transplantation,and improve the prognosis of patients with DCD liver transplantation.Methods:the clinical data of 98 donors and recipients of DCD liver transplantation in the organ transplantation center of our hospital since 2000 were retrospectively analyzed,including: Including recipients of gender,age,whether the Child-Pugh score,malignant tumor,the Model for end-stage liver disease(Model for end-stage liver diseases,length of hospital stay,whether blood compatibility,the degree of liver fatty liver,warm ischemia time,cold ischemia time,operation time,intraoperative blood loss,whether secondary migration,biliary complications,perioperative infection,rejection,Primary graft loss function(Primary non function,PNF)and other clinical data.According to whether EAD occurred after operation,the 25 subjects were divided into EAD group and non-ead group.The differences between the two groups were compared.Results:the incidence of EAD after DCD liver transplantation was 32%(8/25),11 female cases(44%)and 14 male cases(56%);Eight cases were malignant tumors(primary liver cancer,bile duct cell carcinoma,etc.),accounting for 32%;Fatty liver donor was found in 5 cases,accounting for20%;Among the 25 subjects,8(32%)had EAD after transplantation.Single-factor analysis showed that fatty liver degree(P=0.018),cold ischemia time(P=0.018)and recipient malignant tumor(P=0.025)were related to the occurrence of EAD after DCD donor liver transplantation.By analyzing the relationship between EAD and postoperative complications after DCD liver transplantation,the incidence of PNF was correlated with EAD(P=0.024).Conclusion:the higher incidence of EAD after DCD liver transplantation has a serious influence on the prognosis of recipient and graft.In this case,the recipient was malignant tumor and cold ischemia time,as well as the degree of donor fatty liver were risk factors for EAD after DCD liver transplantation.Meanwhile,EAD after DCD liver transplantation obviously promoted the probability of postoperative primary graft dysfunction.The study and exploration of this paper have opened up a new idea for better donor/recipient matching,reduction of postoperative EAD incidence and reduction of postoperative complications.