The Lactate-to-Platelet Ratio: A Novel Predictor for Short-Term Early Allograft Failure After Liver Transplantation

Document Type

Article

Publication Date

12-1-2021

Publication Title

Transplantation proceedings

Abstract

BACKGROUND: Early allograft dysfunction (EAD) is a criterion to evaluate initial graft dysfunction associated with inferior graft survival and postoperative complications after liver transplantation (LT). This study defined the lactate-to-platelet ratio (LPR) as lactate level immediately post-LT/platelet count on postoperative day 1 and evaluated its association with EAD and short-term graft failure.

MATERIALS AND METHODS: This study reviewed 434 deceased-donor LTs from individuals with confirmed brain death between January 2008 and December 2014. The area under the curve (AUC) was used to compare the predictive capacity for 3-month graft survival between EAD and the LPR. Along with LPR, the risk factors for 3-month graft failure were analyzed by multivariate analysis.

RESULTS: EAD was reported in 127 patients (31%). The LPR in patients with EAD was significantly higher than that in patients without EAD (9.8 vs 5.9, P < .001). In the multivariate analysis, both the LPR (per 1.0 increase) and EAD were independent risk factors for 3-month graft failure (hazard ratio [HR] =1.03, P = .03; and HR = 9.14, P = .001). The comparison of the AUCs between the LPR and EAD showed no significant difference (0.79 vs 0.78, P = .84), whereas the combination of EAD and LPR had a better predictive capacity than EAD alone (0.86 vs 0.78, P < .001). The LPR showed an inverse relationship for predicting 3-month graft survival.

CONCLUSIONS: The LPR is a continuous parameter that enables prediction of initial graft function and estimation of the 3-month graft failure rate with the advantages of early availability and simple calculations.

Medical Subject Headings

Transplant and Abdominal Surgery

PubMed ID

34756715

Volume

53

Issue

10

First Page

2993

Last Page

2999

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