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English Abstract
Journal Article
[Primary non function of hepatic allograft: 18 years experience of Guillermo Almenara Irigoyen National Hospital - EsSalud].
Revista de Gastroenterología del Perú : órgano Oficial de la Sociedad de Gastroenterología del Perú 2020 October
INTRODUCTION: The primary nonfunction of the graft (PNF) after liver transplantation is acute graft failure, in the absence of some causal factor, such as acute thrombosis of the hepatic artery or portal vein.
OBJECTIVES: Describe the perioperative characteristics of Liver transplant patients who presented NFPI in the Transplant Department of the Guillermo Almenara Irigoyen Hospital.
MATERIALS AND METHODS: Retrospective, descriptive and cross-sectional study. From March 2000 to March 2018; 249 liver transplants were performed. The PNF was defined with y he criteria of OPTN/UNOS, manifested by increased transaminases (>3,000 UI/ml), coagulopathy (INR >2.5), high lactate levels (>4 mEq/l), PH in acidosis: PH arterial ≤7.30 and/or venous ≤7.25 and hemodynamic instability that requires support with vasoactive drugs. It can lead to death without emergency retransplantation.
RESULTS: 8 patient with PNF were diagnosed with a prevalence of 3.7%, the age of recipients was 51.5±8.45 years, the base MELD score 13.13±3.8 (range 6-18). The characteristics of the donors, the age was 38.5±14.48 years, all ABO identical to the recipients, the geographical distribution: 7 of metropolitan Lima and 1 in Tacna. The cause of encephalic death 75% hemorrhagic DCV and 25% severe TEC. Regarding transoperative factors, the CIT 431±143 min [265 - 645 min], and WIT 81.8±46 min [57- 195 min], the stay in the ICU until the death of the patients was 11.13±9.3 days (range 2-31 days), 12.5% was retransplant.
CONCLUSIONS: The prevalence of PNF after liver transplant in our center is 3.7%. Similar to the series reported by other center, and is associated with high mortality without retransplantation.
OBJECTIVES: Describe the perioperative characteristics of Liver transplant patients who presented NFPI in the Transplant Department of the Guillermo Almenara Irigoyen Hospital.
MATERIALS AND METHODS: Retrospective, descriptive and cross-sectional study. From March 2000 to March 2018; 249 liver transplants were performed. The PNF was defined with y he criteria of OPTN/UNOS, manifested by increased transaminases (>3,000 UI/ml), coagulopathy (INR >2.5), high lactate levels (>4 mEq/l), PH in acidosis: PH arterial ≤7.30 and/or venous ≤7.25 and hemodynamic instability that requires support with vasoactive drugs. It can lead to death without emergency retransplantation.
RESULTS: 8 patient with PNF were diagnosed with a prevalence of 3.7%, the age of recipients was 51.5±8.45 years, the base MELD score 13.13±3.8 (range 6-18). The characteristics of the donors, the age was 38.5±14.48 years, all ABO identical to the recipients, the geographical distribution: 7 of metropolitan Lima and 1 in Tacna. The cause of encephalic death 75% hemorrhagic DCV and 25% severe TEC. Regarding transoperative factors, the CIT 431±143 min [265 - 645 min], and WIT 81.8±46 min [57- 195 min], the stay in the ICU until the death of the patients was 11.13±9.3 days (range 2-31 days), 12.5% was retransplant.
CONCLUSIONS: The prevalence of PNF after liver transplant in our center is 3.7%. Similar to the series reported by other center, and is associated with high mortality without retransplantation.
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