Neuromuscular paralysis as a pharmacodynamic probe to assess organ function during liver transplantation

The number of patients awaiting liver transplantation still widely exceeds the number of donated organs available. Patients receiving extended criteria donor (ECD) organs are especially prone to an aggravated ischemia reperfusion syndrome during liver transplantation leading to massive hemodynamic stress and possible impairment in organ function. Previous studies have demonstrated aprotinin to ameliorate reperfusion injury and early graft survival. In this single center retrospective analysis of 84 propensity score matched patients out of 274 liver transplantation patients between 2010 and 2014 (OLT), we describe the association of aprotinin with postreperfusion syndrome (PRS), early allograft dysfunction (EAD: INR 1,6, AST/ALT > 2000 within 7–10 days) and recipient survival. The incidence of PRS (52.4% vs. 47.6%) and 30-day mortality did not differ (4.8 vs. 0%; p = 0.152) but patients treated with aprotinin suffered more often from EAD (64.3% vs. 40.5%, p = 0.029) compared to controls. Acceptable or poor (OR = 3.3, p = 0.035; OR = 9.5, p = 0.003) organ quality were independent predictors of EAD. Our data do not support the notion that aprotinin prevents nor attenuates PRS, EAD or mortality.

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Effect of Aprotinin on Liver Injury After Transplantation of Extended Criteria Donor Grafts in Humans: A Retrospective Propensity Score Matched Cohort Analysis

10.21203/rs.3.rs-110976/v1 ◽

2020 ◽

Author(s):

Anna Roehl ◽

Marc Hein ◽

Anne Andert ◽

Rolf Rossaint ◽

Karsten Junge ◽

...

Keyword(s):

Liver Transplantation ◽

Propensity Score ◽

Ischemia Reperfusion ◽

Cohort Analysis ◽

Organ Function ◽

Extended Criteria Donor ◽

Number Of Patients ◽

Organ Quality ◽

Early Graft ◽

Early Allograft Dysfunction

Abstract Background: The number of patients awaiting liver transplantation still widely exceeds the number of donated organs available. Patients receiving extended criteria donor (ECD) organs are especially prone to an aggravated ischemia reperfusion syndrome during liver transplantation leading to massive hemodynamic stress and possible impairment in organ function. Previous studies have demonstrated aprotinin to ameliorate reperfusion injury and early graft survival. Methods: In this single center retrospective analysis of 84 propensity score matched patients out of 290 liver transplantation patients between 2010 and 2014 (OLT), we describe the association of aprotinin with postreperfusion syndrome (PRS), early allograft dysfunction (EAD: INR  1,6, AST/ALT >2000 within 7-10 days) and recipient survival. Results: The Incidence of PRS (52,4% vs 47,6%) and 30-day mortality did not differ (4.8 vs 0%; p=0.152) but patients treated with aprotinin suffered more often from EAD (64,3% vs 40,5%, p=0.029) compared to controls. Acceptable or poor (OR=3.3, p=0.035; OR=9.5, p=0.003) organ quality were independent predictors of EAD. Conclusion: Our data does not support the notion that aprotinin prevents nor attenuates PRS, EAD or mortality.

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Local secretion of TNF-α from the liver does not correlate with endotoxin, IL-6, or organ function in the early phase after orthotopic liver transplantation

Transplant International ◽

10.1007/s001470050851 ◽

2001 ◽

Vol 14 (2) ◽

pp. 80-86

Author(s):

S. Tange ◽

Yvonne Höfer ◽

Martin Welte ◽

Matthias Anthuber ◽

Karl W. Jauch ◽

...

Keyword(s):

Liver Transplantation ◽

Orthotopic Liver Transplantation ◽

Early Phase ◽

Organ Function ◽

Tnf Α

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Clinical Biochemistry Services for Liver Transplantation

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/000456327501200104 ◽

1975 ◽

Vol 12 (1-6) ◽

pp. 14-18 ◽

Cited By ~ 1

Author(s):

J. G. Lines

Keyword(s):

Liver Transplantation ◽

Clinical Biochemistry ◽

Working Hours ◽

Liver Transplants ◽

Organ Function ◽

Specific Test ◽

Clinical Biochemistry Laboratory ◽

Diagnosis Of Rejection ◽

Clinical Biochemist

The first significant successes with human liver transplantation took place only in 1968, but the future for this new surgical procedure now seems assured. Its success is heavily dependent upon the provision of pathology services, in particular from clinical biochemistry. The experiences with some of the 39 British liver transplants carried out so far are recorded. At operation, a minimum of 20 technician-hours, usually outside normal working hours, is called for. In the immediate post-operative period, intensive biochemical monitoring is essential. Once the major homeostatic mechanisms are re-established after surgery, the principal biochemical investigations are those of organ function. While no specific test for rejection is yet available, the diagnosis of rejection can be made from results of the routine pathology investigations. The role of the clinical biochemistry laboratory in the management of these patients is to provide reliable results seven days a week on a range of tests. The clinical biochemist is also well placed to contribute to the solution of some of the outstanding problems of organ transplantation.

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