Early Graft Failure
The increasing organ donor shortage and widening indications for transplants has forced the use of liver allografts with expanded criteria that are allocated to sicker and more decompensated recipients, allowing a greater volume of transplants. Furthermore, advances in surgical technique have allowed the use of partial liver grafts both split and living donor in order to increase to the donor pool. Consequently, graft dysfunction, graft failure, and small for size syndrome (SFSS) have become more important than ever. Clinically, post-liver transplant graft failure is a continuum ranging from an ambiguous and easily reversible graft dysfunction to a complete absence of function called primary non-function. The incidence of graft dysfunction varies from 13 to 27% and the incidence of primary non-function affects 4 to 7% of deceased donor liver grafts [1, 2]. With living donor transplantation, cold and warm ischemia times are minimal and donor quality typically excellent...
KeywordsLiver function Acidosis Liver blood flow Small for size syndrome Ischemia-reperfusion injury Early allograft dysfunction
- 1.Maring JK, Klompmaker IJ, Zwaveling JH, Kranenburg K, Ten Vergert EM, Slooff MJ. Poor initial graft function after orthotopic liver transplantation: can it be predicted and does it affect outcome? An analysis of 125 adult primary transplantations. Clin Transpl. 1997;11:373–9.Google Scholar
- 4.Roloff JS. Disseminated intravascular coagulation and other acquired bleeding disorders. In: Levin DL, Morris FC, editors. Essentials of pediatric intensive care. St. Louis: Quality Medical Publishing; 1990.Google Scholar