Abstract
Background: There are several risk factors for early allograft dysfunction (EAD) after donation after citizen death (DCD) liver transplantation. This study explored whether elevated donor’s seral creatinine increases the risk of EAD after DCD liver transplantation.
Materials and Methods: The study enrolled 224 primary adult DCD liver transplantation recipients. Univariate and multivariate logistic regression analyses were performed, and receiver operating characteristic curves were constructed. Perioperative clinical and laboratory variables were assessed for their association with the prevalence of EAD using the inverse probability of treatment weighting (IPTW) and 1:3 propensity score (PS) matching (Group A, n=53; Group B, n=124) analysis.
Results: Forty-eight recipients (21.4%) developed EAD. All cases were divided into two groups (Group 1 [donor’s seral creatinine > 170μmol/L, n = 55] and Group 2 [donor’s seral creatinine ≤ 170μmol/L, n = 169]). Multivariate logistic regression analyses revealed that the donor’s age >60 years old (OR 5.927, 95CI% 2.144-16.387, p=0.001), BMI >24 (OR 2.818, 95CI% 1.359-5.845, p=0.005), with hypertension (OR 2.308, 95%CI 1.086-4.902, p=0.030), ICU stay >7 days (OR 3.369, 95% CI 1.449-7.832, p=0.005), and seral creatinine >170 μmol/L (OR 2.841, 95%CI 1.309-6.164, p=0.008) were independent risk factors for EAD. Moreover, the donor’s seral creatine >170 μmol/L was associated with incidence of EAD after adjusting for IPTW (OR 2.714, 95%CI 1.407-5.234, p=0.003), and after 1:3 PS matching (34.0% vs 18.5%, OR 2.258, 95%CI 1.092-4.671, p < 0.05).
Conclusions: Elevated donor’s seral creatinine increased the risk of postoperative EAD, which might be a novel predictor of EAD after DCD liver transplantation.