Prediction of poor graft function by means of gastric tonometry in patients undergoing liver transplantation

Valter Perilli, Cristina Modesti, Alfonso Wolfango Avolio, Liliana Sollazzi, Paola Aceto, Francesca Vitale, Pierpaolo Ciocchetti, Teresa Sacco, Alessia Adduci, Carlo Lai

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

5 Citazioni (Scopus)

Abstract

INTRODUCTION. Splanchnic hypoperfusion appears to play a key role in the failure of functional recovery of the graft after orthotopic liver transplantation (LT). The aim of this study was to determine if alterations of tonometric parameters, which are related to splanchnic perfusion, could predict poor graft function in patients undergoing LT. MATERIALS AND METHODS: After Ethics Committee approval, 68 patients undergoing LT were enrolled. In all the patients, regional-arterial CO2 gradient (Pr-aCO2) was recorded; in addition, the difference between Pr-aCO2 recorded at anhepatic phase (T1) and at the end of surgery (T2) (T2- T1 = ΔPr-aCO2) was calculated. Poor graft function was determined on the basis of Toronto's classification 72 hours after LT. Student t-test and logistic regression analysis were used for statistical purpose. Results. ΔPr-aCO2 was significantly greater in patients with poor graft function (3.5 ± 13.2) compared to patients with good graft function (-5.8 ± 12.3) (p = 0.014). The logistic regression analysis showed that the ΔPr-aCO2 was able to predict the onset of poor graft function (p = 0.037). A value of ΔPr-aCO2 ≥ -4 was associated with poor graft function with a sensibility of 93.3% and a specificity of 42.3%. CONCLUSION. Our study suggests that the change of Pr-aCO2 may be a valuable index of graft dysfunction. Gastric tonometry might give early prognostic information on the graft outcome, and it may aid clinicians in planning a more strict follow-up and proper interventions in order to improve graft survival.
Lingua originaleEnglish
pagine (da-a)54-59
Numero di pagine6
RivistaAnnals of Hepatology
Volume13
DOI
Stato di pubblicazionePubblicato - 2014

Keywords

  • Adult
  • Carbon Dioxide
  • Female
  • Gastric Mucosa
  • Graft Survival
  • Humans
  • Hydrogen-Ion Concentration
  • Liver
  • Liver Cirrhosis
  • Liver Transplantation
  • Logistic Models
  • Manometry
  • Middle Aged
  • Prognosis
  • Splanchnic Circulation
  • Transplants
  • Treatment Outcome

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