Risk Factors Of Early Allograft Dysfunction Of Ex-Vivo Liver Resection And Autotransplantation

Objective: To analyze and summarize the risk factors of EAD after ELRA,to provide reference for the prevention and treatment of EAD,and to improve the prognosis of ELRA patients by evaluating and predicting the occurrence of EAD.Methods: The clinical data of 64 patients with ELRA from March 2013 to October 2018 in the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed.According to the occurrence of EAD after operation,the patients were divided into EAD group and non-EAD group.The general data,preoperative liver function index,operation time,intraoperative blood loss,anhepatic period,cold ischemia time,warm ischemia time,inferior vena cava occlusion time,percentage of graft liver volume to standard liver volume,intraoperative red blood cell input,intraoperative plasma input and postoperative hospital time were compared between the two groups.Results: The incidence of EAD after ELRA was 35.59%(21/59).The cumulative survival rates of recipients were 94.70%and 90.90%,89.50% and 65.60%(P=0.038)at 1 and 3 years after operation,and 72.70%and 46.80%(P<0.001)at 3 years after operation.Multivariate analysis showed that cold ischemia time(OR = 1.09,95% CI = 1.005-1.033,P = 0.038)and the percentage of graft liver volume to standard liver volume(OR = 0.952,95% CI = 0.91-0.997,P = 0.038)were independent risk factors for EAD after ELRA.In addition,there was a significant correlation between the occurrence of EAD and the occurrence of primary non function(P< 0.001).Conclusion: The occurrence of EAD after ELRA seriously affects the prognosis of patients.Cold ischemia time and the percentage of graft liver volume to standard liver volume were independent risk factors for EAD after ELRA.The occurrence of EAD will significantly increase the probability of primary non function.