Risk Factors Of Primary Graft Dysfunction Of Liver Transplantation From Donation After Citizen's Death

Objective:To summarize the occurrence of primary graft dysfunction(PGD)of liver transplantation from donation after citizen's death(DCD)and to analyze the risk factors of PGD.Methods:A retrospective study was performed to observe the available clinical data of 88 patients who had received liver transplantation from DCD between February 2014 and April 2016 in organ transplantation center,the affiliated hospital of Qingdao university.The donor data,including: gender,age,blood type,the cause of death,time of intensive care unit(ICU)stay and the degree of steatosis,cold ischemia time(CIT),warm ischemia time(WIT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum total bilirubin(TB),and the recipient's data,including: gender,age,blood type,model of primary disease,preoperative model for end-stage liver disease(MELD)score,postoperative time of ICU stay,intraoperative volume of blood loss,the volume of blood transfusion,anhepatic phase,etc.Firstly,the univariate factor analysis was used for the single factor,then results that were significant difference were performed in multivariate analysis of Logistic regression and analyze the risk factors of PGD.Then by graphing the data,we can analyze the 88 recipients who had received liver transplantation from donation after citizen's death survival condition,and compare the statistical difference on survival rate between PGD group and non-PGD group,to summarize the occurrence of PGD of liver transplantation from DCD,analyzing the impaction of the risk factors of PGD on the survival rate of 88 recipients.Results : The occurrence rates of PGD after liver transplantation was 52.3%.The recipient's cumulative survival rates of PGD group and non-PGD group after 1,6 and 12 month were 86.37%,81.83%,74.73%;92.47%,87.47%,80.06%,respectively.Nostatistically significant difference was observed(P=0.39).The univariate analysis suggested that the CIT?8h,WIT?20min,donor's time of ICU stay?72h and preoperative MELD score of recipients ?20 are influencing factors of PGD.However,the multivariate analysis revealed that CIT?8h,donor's time of ICU stay ?72h and MELD score?20 were independent influencing factors affecting PGD(P=0.003,OR=3.925,95%CI:1.579~9.757;P=0.043,OR=2.732,95%CI:1.034~7.218).Conclusions:CIT?8h,donor's time of ICU stay ?72h and MELD score ?20 of recipients were independent influencing factors of PGD.However,the WIT?20min was a potential factors influencing the occurrence of PGD.Therefore,the incidence of PGD could be reduced by removing those influencing factors and timely organ donation,prognosis of the recipients after liver transplantation could be improved.