Risk Factors Of Early Allograft Dysfunction In Donation After Cardiac Death Liver Transplantation

BackgroundEarly allograft dysfunction (EAD) is one of server complications after liver transplantation,which is associated with the success rate of LT and inferior patient survival. Donation after cardiac death (DCD) has been regarded as an important way to expand the source of liver donation. In this study,we analyzed the risk factors of EAD in DCD liver transplantation in order to predict the occurrence of EAD and provide reference to the prevention and treatment of EAD.MethodWe retrospectively analyzed the clinical data of 187 patients undergoing DCD liver transplantation between April 2010 and December 2014.ResultsThe incidence of EAD was found to be 33.7%(63/187). The patient survival rates for those with EAD and those with no EAD at 1,3 years were 72.9% and 88.7%,60.0% and 81.7%(P=0.004). Allograft survival rates for recipients with EAD and those with no EAD at 3 years were 79.1% and 96.6%(P<0.001). Multivariate analysis demonstrated that the cold ischemia time(OR= 1.12,95% CI=1.02-1.24,P=0.021)and cancer as a secondary diagnosis(OR=2.30,95% CI=1.19-4.44,P=0.014)were independent risk factors for occurrence of EAD.Moreover,There was a significant association between EAD and the development of primary non function (P<0.001).ConclusionEAD is severely associated with inferior patient and graft survival in recipients of DCD liver allografts. The cold ischemia time and cancer as a secondary diagnosis are independent risk factors for occurrence of EAD in DCD liver transplantation. EAD will significantly increase the incidence of primary non function in DCD liver transplantation.