Risk Factors for Dysfunctional Liver Graft Response: A Case-Control Study.
Layana de Paula Cavalcante, João Cruz Neto, Maria Beatriz Freire Alves and 5 others
PMID 42144252WHAT IT FOUND
In 588 liver transplant records, younger recipient age, higher BMI, renal dysfunction, fewer transfusions, older male donors, high donor sodium, and longer ischemia times were associated with early graft dysfunction.
This is risk profiling, not proof of cause.
Key findings
01The final analysis included 588 liver transplant recipients: 371 met criteria for dysfunctional liver graft response and 217 did not.
02Multivariable logistic regression identified nine independent variables associated with dysfunctional liver graft response.
03Recipient renal dysfunction was associated with twice the likelihood of dysfunctional liver graft response (OR = 2.03; p = 0.006).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used retrospective medical records, so incomplete or inaccurate documentation could have affected the data. It was conducted at a single centre, so the findings may not generalise to other transplant programmes. The final sample was smaller than planned, reducing statistical power from 80% to 73%, which may have hidden weaker associations. Cases and controls were classified after the outcome occurred, and no random allocation was used, so selection and sampling bias are possible. Only complete and internally consistent records were included, which may have introduced bias related to record quality. The design was not intended to estimate causal effects, so associations cannot be read as causes. Transfusion volume may be an imperfect proxy for clinical severity or perioperative management, so its association should be interpreted cautiously. The hepatic encephalopathy association was not supported by prior studies and may be spurious.
Declared interests
Funded by CNPQ grants No. 310378/2023-0 and 313 495/2021-1. The authors declare no conflicts of interest.
The easy way to misread this
Do not read these associations as proof that any factor caused graft dysfunction, or that lower transfusion support is protective. The study was retrospective, single centre, and not designed to estimate causal effects.