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21 May 2009

Portal flow – a reliable predictor of early liver graft function

M Pacholczyk, B Łągiewska, M Kosieradzki, W Lisik, G Gontarczyk, L Adadyński, A Chmura

Ann Transplant 2009; 14(1): 27-27 :: ID: 880296


Background: Studies of factors responsible for early liver graft function were
conducted in our institution. Aim of the study was to identify most simple and useful test for predicting early liver graft function.
Material/Methods: Fifty-six livers were classified as transplantable based on
routine donor demographics, hemodynamic and biochemistry as well as
macroscopic assessment by the surgeon on retrieval. Moreover, portal, arterial and parenchymal hepatic blood flow as well as HE histology, ketone index, bile acids chromatography, arachidonic acid metabolites were also studied. Post-transplant early liver function was categorized based on modified Neuhaus classification (2 points assigned for each of: bile output <50ml/d, AST >1800 IU/L, ALT >1600 IU/L, INR >1.7 despite plasma infusions, poor initial function (PIF) was diagnosed with score >6).
Results: Of 56 patients, only 4 had PIF. No primary nonfunction was seen.  Neither histology, nor biochemical tests proved useful in prediction of this
complication. Of multiple methods of flow assessment, portal blood flow (PF)
30 minutes after reperfusion was the most reliable factor. It differed significantly between good (GF) and poor initial function groups.

Keywords: Liver Transplantation

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358