{'fraction_non_alphanumeric': 0.048575129533678756, 'fraction_numerical': 0.03756476683937824, 'mean_word_length': 5.410788381742739, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Analysis of ischemia/reperfusion injury in time‐zero biopsies predicts liver allograft outcomes

Ischemia/reperfusion injury (IRI) that develops after liver implantation may prejudice long‐term graft survival, but it remains poorly understood. Here we correlate the severity of IRIs that were determined by histological grading of time‐zero biopsies sampled after graft revascularization with patient and graft outcomes. Time‐zero biopsies of 476 liver transplants performed at our center between 2000 and 2010 were graded as follows: nil (10.5%), mild (58.8%), moderate (26.1%), and severe (4.6%). Severe IRI was associated with donor age, donation after circulatory death, prolonged cold ischemia time, and liver steatosis, but it was also associated with increased rates of primary nonfunction (9.1%) and retransplantation within 90 days (22.7%). Longer term outcomes in the severe IRI group were also poor, with 1‐year graft and patient survival rates of only 55% and 68%, respectively (cf. 90% and 93% for the remainder). Severe IRI on the time‐zero biopsy was, in a multivariate analysis, an independent determinant of 1‐year graft survival and was a better predictor of 1‐year graft loss than liver steatosis, early graft dysfunction syndrome, and high first‐week alanine aminotransferase with a positive predictive value of 45%. Time‐zero biopsies predict adverse clinical outcomes after liver transplantation, and severe IRI upon biopsy signals the likely need for early retransplantation. Liver Transpl 21:487‐499, 2015. © 2015 AASLD.