Description

Markmann et al identified factors during liver transplant surgery that predict poor outcome postoperatively. These can help identify patients who may require closer monitoring and possibly early retransplantation. The authors are from the University of Pennsylvania in Philadelphia.


 

Parameters:

(1) bile output during surgery

(2) urine output during surgery

(3) number of platelet concentrates transfused

Parameter

Finding

Points

bile output during surgery

good to fair

0

 

poor

1

urine output during surgery

>= 2.0 mL per kg per hour

0

 

< 2.0 mL per kg per hour

1

platelet concentrates

< 20 concentrates transfused

0

 

>= 20 concentrates transfused

1

 

where:

• A plateletpheresis product may contain the equivalent of 6 to 8 platelet concentrates.

 

number of risk factors for poor outcome =

= SUM(points for the 3 intraoperative parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 3

• The presence of one or more of the risk factors was associated with a prolonged ICU stay and longer hospitalization.

• The absence of all risk factors was associated with good graft survival.

 


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