Donor Hepatectomy and Implantation Time Are Associated With Early Complications After Liver Transplantation: A Single-center Retrospective Study.

BACKGROUND: Donor hepatectomy and liver implantation time reduce long-term graft and patient survival after liver transplantation. It is not known whether these surgical times influence early outcomes after liver transplantation. METHODS: This single-center study evaluated the effect of donor hepatectomy and implantation time on the risk of nonanastomotic biliary strictures occurring within 1 year and of early allograft dysfunction after deceased-donor solitary liver transplantation, adjusting for other donor, recipient, and surgical factors. RESULTS: Of 917 transplants performed between 1/2000 and 12/2016, 106 (11.56%) developed nonanastomotic biliary strictures and 247 (27%) developed early allograft dysfunction. Donor hepatectomy time (median 35 min, IQR: 26-46) was an independent risk factor of nonanastomotic biliary strictures (adjusted hazard ratio (HR): 1.19, 95% CI: 1.04-1.35, p=0.01). Implantation time (median 80 min, IQR: 69-95) was independently associated with early allograft dysfunction (adjusted odds ratio (OR): 1.15, 95% CI:1.07-1.23, p<0.0001). The risk of early allograft dysfunction was increased by anastomosis time of both portal vein (adjusted OR: 1.26, 95% CI: 1.12-14.42, p=0.0001) and hepatic artery (adjusted OR: 1.13, 95%CI: 1.04-1.22, p=0.005). The magnitude of these effects was similar in donation after circulatory death liver grafts. CONCLUSIONS: Donor hepatectomy and implantation time negatively affect short-term outcomes.

Jaar van publicatie:2021

BOF-keylabel:ja

IOF-keylabel:ja

BOF-publication weight:6

CSS-citation score:2

Authors from:Higher Education

Toegankelijkheid:Open