Cold ischemia time is an important risk factor for post-liver transplant prolonged length of stay

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Evelyn T PanAbbas Rana

Abstract

Risk analysis of cold ischemia time (CIT) in liver transplantation has largely focused on patient and graft survival. Posttransplant length of stay is a sensitive marker of morbidity and cost. We hypothesize that CIT is a risk factor for posttransplant prolonged length of stay (PLOS) and aim to conduct an hour-by-hour analysis of CIT and PLOS. We retrospectively reviewed all adult, first-time liver transplants between March 2002 and September 2016 in the United Network for Organ Sharing database. The 67,426 recipients were categorized by hourly CIT increments. Multivariate logistic regression of PLOS (defined as >30 days), CIT groups, and an extensive list of confounding variables was performed. Linear regression between length of stay and CIT as continuous variables was also performed. CIT 1-6 hours was protective against PLOS, whereas CIT >7 hours was associated with increased odds for PLOS. The lowest odds for PLOS were observed with 1-2 hours (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.45-0.92) and 2-3 hours (OR, 0.65; 95% CI, 0.55-0.78) of CIT. OR for PLOS steadily increased with increasing CIT, reaching the greatest odds for PLOS with 13-14 hours (OR, 2.05; 95% CI, 1.57-2.67) and 15-16 hours (OR, 2.06; 95% CI,...Continue Reading

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Citations

Aug 7, 2018·Current Opinion in Organ Transplantation·Laura C BurlageGerald Brandacher
Mar 27, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Flavio PaternoShimul Shah
Aug 20, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Meng ShaQiang Xia
Mar 11, 2020·Journal of Clinical Medicine·Isabel LegazManuel Muro
May 21, 2020·Nature Protocols·Reinier J de VriesKorkut Uygun
Nov 21, 2018·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Amr BadawyShinji Uemoto
Jan 23, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·David WallaceWilliam Bernal
Aug 31, 2020·World Journal of Transplantation·Kelley NúñezAri Cohen
Sep 22, 2020·Trends in Molecular Medicine·Kourosh Saeb-ParsyMichael P Murphy
Oct 23, 2020·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Si-Ho KimKyong Ran Peck
Oct 30, 2020·Journal of Clinical Medicine·Suk Kyun HongKyung-Suk Suh
Dec 31, 2020·International Journal of Molecular Sciences·Marc Micó-CarneroCarmen Peralta
Feb 4, 2021·Journal of Nursing Care Quality·Lisa GuertinChristopher Brown
Sep 22, 2021·Clinical Transplantation·Ignacio Sáez de la FuenteJuan Carlos Montejo González
Dec 24, 2021·Current Opinion in Organ Transplantation·Stephanie Hsiao, Kiran K Khush

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