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Synergistic effect of cold and warm ischemia time on postoperative graft function and outcome in human liver transplantation.

Abstract：

:Prolonged cold ischemia time (CIT) during graft preservation and warm ischemia time (WIT) during rewarming time have been reported to cause postoperative graft dysfunction after orthotopic liver transplantation (OLT). However, the effects of both CIT and WIT in combination on patient and graft survivals are not yet defined. The aim of this study was to determine whether simultaneously prolonged CIT and WIT were associated with early graft outcomes after clinical OLT. For analysis of liver graft survival within 90 days of OLT and postoperative graft function, 186 consecutive OLT cases were divided into four groups as follows: group A, CIT < 12 hours and WIT < 45 minutes; group B, CIT > 12 hours and WIT < 45 minutes; group C, CIT < 12 hours and WIT > 45 minutes; and group D, CIT > 12 hours and WIT > 45 minutes. The graft loss rates were 5.4% in group A, 9.8% in group B, 11.1% in group C, and 42.9% in group D. The mean highest aspartate aminotransferase (AST) value after OLT in group D (3352.3 +/- 569.4 U/L) was significantly greater than those in groups A (1411.7 +/- 169.2 U/L) and B (1931.3 +/- 362.6 U/L). The simultaneously prolonged cold and warm ischemia times significantly caused hepatic allograft injury and failure, suggesting some cumulative effects of CIT and WIT on postoperative graft function.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Totsuka E,Fung JJ,Hakamada K,Ohashi M,Takahashi K,Nakai M,Morohashi S,Morohashi H,Kimura N,Nishimura A,Ishizawa Y,Ono H,Narumi S,Sasaki M

doi

10.1016/j.transproceed.2004.08.068

subject

Has Abstract

pub_date

2004-09-01 00:00:00

pages

1955-8

issue

7

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(04)00938-8

journal_volume

36

pub_type

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