Early Allograft Dysfunction: Causes, Recognition, and Management
Early Allograft Dysfunction: Causes, Recognition, and Management
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DOI：
10.1002/lt.23746
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发表时间：
2013-11-01
影响因子：
4.6
通讯作者：
Deschenes, Marc
中科院分区：
文献类型：
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作者：
Deschenes, Marc
1.早期同种异体移植物功能障碍（EAD）定义了肝移植术后早期移植物的边缘功能。它已在终末期肝病模型时代得到验证。2. EAD是肝移植术后发病和死亡的重要原因。3.供体和受体的危险因素都与EAD的发展有关。4.统计模型的使用有助于预测给定的捐赠者-接受者匹配的EAD。5.与EAD相关的细胞因子谱的鉴定可能有助于确定未来的潜在干预措施。当我们试图为我们的肝移植等待名单上尽可能多的候选人提供移植物时，我们呼吁扩大我们的器官供体库。一个问题是早期移植功能的可变性。虽然术后最初48 ~ 72小时内转氨酶轻度升高是相对良性的，但原发性移植物无功能需要紧急再次移植。新植入移植物的边缘功能也是不良事件。虽然在移植后早期定义这种功能不良的移植物的命名没有很好的标准化，但公认它们是受体发病和死亡的重要原因。
1. Early allograft dysfunction (EAD) defines grafts with marginal function early after liver transplantation. It has been validated in the Model for End-Stage Liver Disease era. 2. EAD is an important cause of morbidity and mortality after liver transplantation. 3. Both donor and recipient risk factors are associated with the development of EAD. 4. The use of statistical models has helped to predict EAD for given donor-recipient matches. 5. The identification of cytokine profiles associated with EAD may help to define potential interventions in the future.As we try to offer grafts to as many candidates as possible on our liver transplant waiting list, we are called to expand our organ donor pool. One problem is the variability in early graft function. Although a mild postoperative rise in aminotransferases during the first 48 to 72 hours is a relatively benign event, primary graft nonfunction requires emergency retransplantation. Marginal function of the newly implanted graft also represents an adverse event. Although the nomenclature for defining such poorly functioning grafts in the early posttransplant period is not well standardized, it is accepted that they are an important cause of morbidity and mortality for recipients.