Volume 11 Issue 5
Sep.  2020
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Liu Hao, Dong Jiayong, Fu Zhiren, et al. Effect of cold ischemia time on early graft function and acute rejection after liver transplantation[J]. ORGAN TRANSPLANTATION, 2020, 11(5): 578-583. doi: 10.3969/j.issn.1674-7445.2020.05.008
Citation: Liu Hao, Dong Jiayong, Fu Zhiren, et al. Effect of cold ischemia time on early graft function and acute rejection after liver transplantation[J]. ORGAN TRANSPLANTATION, 2020, 11(5): 578-583. doi: 10.3969/j.issn.1674-7445.2020.05.008
shu

Effect of cold ischemia time on early graft function and acute rejection after liver transplantation

doi: 10.3969/j.issn.1674-7445.2020.05.008

  • Department of Organ Transplantation, the Affiliated Changzheng Hospital of Naval Medical University, Shanghai 200003, China

More Information
  • Corresponding author: Yang Jinghui, Email: yjh@smmu.edu.cn
  • Received Date: 2020-06-04
    Available Online: 2021-01-19
  • Publish Date: 2020-09-15
    Abstract
  •   Objective  To evaluate the effect of different cold ischemia time (CIT) on early graft function and acute rejection (AR) after liver transplantation.  Methods  Clinical data of 218 donors and recipients undergoing liver transplantation were collected and analyzed. All patients were divided into three groups according to the CIT of donor liver: group A (CIT≤6 h, n=60), group B (6 h < CIT≤10 h, n=89) and group C (CIT > 10 h, n=69). Blood samples were collected on the 1, 7 and 14 d after liver transplantation. The changes of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and adenosine triphosphate (ATP) in CD4+T cells were detected. The incidence of AR and the positive rate of C4d deposition were analyzed.  Results  The ALT, AST and LDH levels in each group reached the peak on the 1 d after operation, and then gradually decreased. The indexes in each group were almost equivalent on the 14 d. An interaction effect existed between postoperative time and group. After liver transplantation, ATP levels in CD4+T cells were gradually increased in each group, peaked at postoperative 7 d, and then decreased gradually. An interaction effect was noted between postoperative time and group. The incidence of AR in groups A, B and C was 10%, 12% and 28%. Compared with group C, the incidence of AR in groups A and B was decreased significantly (both P < 0.05/3). The positive rate of C4d deposition in AR recipients of groups A, B and C was 1/3, 45% and 89% respectively. Compared with group C, the positive rate of C4d deposition in group A was decreased significantly (P=0.015).  Conclusions  The prolongation of CIT may lead to aggravation of early-stage liver function injury after liver transplantation, which is more easily to induce humoral AR.

     

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