Risk Factors Of Early Allograft Dysfunction After Organ Donation Liver Transplantation Of The Death Of A Citizen And Correlation Analysis With Postoperative Complications

Objective to analyze the risk factors of EAD after organ donation liver transplantation,to explore the correlation between EAD and complications related to transplant recipients,and the prognosis of EAD,so as to provide effective evidence for liver quality assessment.Methods clinical data were collected from 135 patients who underwent OLT in the Oriental Hospital of Xiamen University from Jan 2015 to Jun 2019.After inclusion and exclusion criteria,they were divided into two groups according to the EAD diagnostic criteria proposed by professor Olthoff:the EAD group(n=42)and Non-EAD group(n=70).Single-factor and multi-factor analysis was performed and ROC curve was drawn.The recovery of liver function was analyzed by Two-way Repeated Measures Anova.Relationship between EAD and early postoperative complications of the receptor was compared pairwise.Survival analysis and COX risk ratio regression were used to analyze the prognostic risk factors of EAD.Results there were 42 cases of EAD(37.5%)in 112 patients.The survival rates of EAD and Non-EAD groups were 81%,66.7%,35.7%VS 91.4%,84.3%,64.3%in 1,6 and 12 months,respectively.Single factor analysis showed that there were significant differences(P<0.05)in WIT,cause of donor death,fatty degeneration of donor liver,sex of recipient,WBC,BUN,C r,ALT and AST,and logistic regression analysis showed that there were significant differences(P<0.05)in CIT and BUN.According to ROC curve analysis and Gordan index,the best cut-off value of donor CIT was 6.5h,with sensitivity of 85%and specificity of 52.9%.Two-way Repeated Measures Anova showed that AST,ALT and TBiL in EAD group were higher than those in Non-EAD group,and there were statistical differences with time.Pulmonary infection was significant difference between EAD group(16/42)and Non-EAD group(12/70)(P<0.05).COX risk ratio regression analysis showed that there was a significant difference in pulmonary infection and vascular complications(P<0.05).The relative risk of pulmonary infection and vascular complications was 2.369 and 3.242.Conclusions donor CIT and recipient BUN are independent risk factors for EAD.The best critical value of donor CIT is 6.5h,which can predict the occurrence of EAD.Pulmonary infection and vascular complications are closely related to EAD,which may increase the risk of death after transplantation.