Transplantation proceedings最新文献

{"title":"Determination of Anti-HLA Antibody Positivity in Kidney Transplant Candidates in a Tissue Typing Laboratory and Results Analysis.","authors":"Hayriye Senturk Ciftci, Demet Kivanc, Cigdem Kekik Cinar, Fatma Savran Oguz","doi":"10.1016/j.transproceed.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.09.010","url":null,"abstract":"<p><strong>Background: </strong>To retrospectively investigate the correlation between anti-HLA antibody PRA identification and single antigen bead (SAB) results and the relationship between mean fluorescence intensity (MFI) values determined using Luminex-based techniques and complement-dependent cytotoxicity (CDC-XM) and flow cytometry (FC-XM) results.</p><p><strong>Material and method: </strong>Between 2017 and 2020, 256 patients with end-stage renal disease who were admitted to the Tissue Typing Laboratory of Istanbul Faculty of Medicine and tested for anti-HLA antibodies were included in the study. The correlation between antigen-specific antibody identification, SAB, CDC-XM, and FC-XM tests was analyzed retrospectively.</p><p><strong>Results: </strong>PRA identification was positive in 78.5% of the patients. Of these patients, 15.2% were class I positive and 31.6% were class II positive. In the SAB test, 171 patients (66.8%) were positive. Of the SAB-positive patients, 16.8% were SAB-I positive and 24.2% were SAB-II positive. Fifty-two percent of patients were FC-XM positive and 10.5% were CDC-XM positive. SAB-I MFI>5141 and SAB-II MFI>7649 values were significantly correlated with positive CDC-XM (p < .001 and p = .048, respectively). SAB-I MFI>2721 and SAB-II MFI>2719 values were correlated with positive FC-XM-B (p = .003 and p = .038, respectively). The highest MFI values for identification were HLA-A:20896, HLA-B:18100, HLA-DRB1:21054, HLA-DQ:24034, and HLA-A:15715, HLA-B:11002, HLA-DR:22400, HLA-DQB1:22700, and DQA1:14782 for SAB.</p><p><strong>Conclusion: </strong>In our study, it was found that some low-titer antibodies that could not be identified using PRA could be detected using SAB. We think it is important to evaluate SAB tests in these patients and to include this region in HLA typing reports because antibodies frequently develop in the HLA-DQA1 region.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Non-neoplastic Portal Vein Thrombosis in Adult Living Donor Liver Transplantation.","authors":"Kamil Yalçın Polat, Şerafettin Yazar, Ahmet Kargı, Serdar Aslan, Bünyamin Gürbulak, Vusal Abdurrahmanov, İbrahim Astarcıoğlu","doi":"10.1016/j.transproceed.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.09.001","url":null,"abstract":"<p><strong>Background: </strong>Nontumoral portal vein thrombosis (PVT) refers to thrombotic occlusion of the PV, affecting both superior mesenteric vein (SMV) and splenic vein owing to portal hypertension in cirrhotic patients. Nontumoral PVT is more frequent in cirrhotic patients with a prevalence ranging from 10-14% to 25%.</p><p><strong>Method: </strong>We evaluated the prevalence, morbidity (rethrombosis, ascites), mortality survival rates and contributing factors in patients with PVT (preoperative/perioperative) who underwent PV thromboendovenectomy.</p><p><strong>Results: </strong>We performed 522 living donor liver transplantations between November 2021 and 2024; 82 patients (46 male/36 female) had non-neoplastic chronic cruoric PVT. The prevalence of PVT is 15.7%. Forty-four patients were classified as Yerdel I, 19 as Yerdel II, and 19 as Yerdel III; 53 patients (65%) had a Model for End-Stage Liver Disease (MELD) score of <15. Rethrombosis was seen in 4 cases (4.87%) and 2 patients died. Twelve mortalities were seen (14.63 %). Two of the 12 deaths were related to rethrombosis.</p><p><strong>Conclusion: </strong>Our mortality rates were similar in patients with and without PVT, and PVT had no impact on mortality. When chronic PVT is detected, transplantation should not be delayed, even if the MELD score is low, because PVT can progress faster than MELD, ultimately increasing mortality.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Early Spontaneous Subcapsular Hematoma in a Transplanted Kidney: The Importance of High Suspicion and Timely Intervention.","authors":"Margot Szabo, Alice Ramistella, Ismail Labgaa, Tobias Zingg","doi":"10.1016/j.transproceed.2025.08.015","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.08.015","url":null,"abstract":"<p><strong>Background: </strong>Subcapsular hematoma (SH) is a rare but serious complication after renal transplantation, potentially leading to graft dysfunction. Through external compression and activation of the renin-angiotensin-aldosterone system a SH can lead to a serious condition known as Page kidney. Early diagnosis and timely intervention are crucial to prevent graft loss.</p><p><strong>Case presentation: </strong>We describe a 67-year-old male who underwent kidney transplantation and developed an SH in the immediate postoperative phase. Despite being hemodynamically stable and asymptomatic, the patient exhibited persistent anuria and rising serum creatinine levels (349 μmol/L). Routine ultrasound (US) revealed a SH (2.5 cm × 4.3 cm × 7.8 cm) compressing the graft. Doppler findings showed normal renal arterial resistive indices. A subsequent non-contrast CT scan confirmed the diagnosis. Given the risk of graft ischemia, surgical decompression via longitudinal and transverse capsular incisions was performed. Postoperatively, diuresis resumed, and renal function improved, with a decline in creatinine levels. The patient was discharged on postoperative day 25 with preserved graft function.</p><p><strong>Conclusion: </strong>SH in transplant recipients is uncommon and often linked to surgical trauma, anticoagulation, or allograft biopsy. While small hematomas may resolve conservatively, larger ones can lead to graft dysfunction. This case highlights the importance of routine postoperative US for early detection, as well as the role of timely surgical intervention in preserving renal function. Given the potential for irreversible ischemia and graft loss, proactive surgical decompression should be favored over conservative management in transplant recipients with significant SH.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Transplant Kidney Infected Hydronephrosis Complicated by Pyonephrosis 15 Years Post-Transplantation: A Case Report and Literature Review.","authors":"Haytham Araibi, Ahsen Razzag, Abdallah Magdy Mohamed Zaky Abdelwahed, Ali Malik","doi":"10.1016/j.transproceed.2025.08.022","DOIUrl":"10.1016/j.transproceed.2025.08.022","url":null,"abstract":"<p><p>We present the case of a 45-year-old male with a history of 2 renal transplants who developed right iliac fossa (RIF) pain, abscess formation, and hydronephrosis in a non-functioning transplanted kidney, a rare and serious complication. The patient underwent prompt surgical intervention, including drainage and subsequent nephrectomy of the non-functioning kidney. This case underscores the challenges of managing long-term post-transplant complications, such as infection, abscess formation, and hydronephrosis, which require timely diagnosis and multidisciplinary management.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Model for End-stage Liver Disease 3.0 Better Than Model for End-stage Liver Disease? Evaluating the Association of Liver Disease Severity Scores With Perioperative Complications in Liver Transplant Recipients.","authors":"Micaella R Zubkov, Hunter B Moore, Maria Baimas-George, Susana Arrigain, Rocio Lopez, Deena Brosi, Kristen Brown, Ivan E Rodriguez, Trevor L Nydam, James J Pomposelli, Elizabeth A Pomfret, Jesse D Schold","doi":"10.1016/j.transproceed.2025.06.022","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.06.022","url":null,"abstract":"<p><strong>Background: </strong>Sequential adaptations to Child-Pugh (CP) and MELD have improved prediction of waitlist mortality in liver transplant (LT). Despite its widespread use as a prognosticator, the association between the MELD score and perioperative adverse events during LT has yet to be evaluated. this study seeks to evaluate whether advances in MELD score calculations correspondingly improve predictions for massive transfusion (MT) and renal failure.</p><p><strong>Methods: </strong>Adult patients undergoing LT at a tertiary institution between 2015 and 2023 were enrolled. MELD, MELD-Na, MELD 3.0, and CP were calculated at time of LT. Massive transfusion (MT) was >6 units of red blood cells before hepatic artery ligation. Renal failure (RF) was defined as requiring dialysis on postoperative-day one. Area-under-the-receiver-operating-characteristic curves (AUC) was estimated for each score and outcome and compared using the DeLong method. Score performance was evaluated using receiver operator curves (ROC) with a high performing assay considered as an area under the curve (AUC) >0.800.</p><p><strong>Results: </strong>Total 265 patients were included; 20 (7.6%) received MT, 31 (11.8%) had RF. For MT, scores performed similarly (CP 0.70 [95% CI: 0.58, 0.81]; MELD 0.69 [0.59, 0.80]; MELD-Na 0.71 [0.61, 0.81]; MELD 3.0 0.69 [0.59, 0.80]). For RF all MELD scores outperformed CP, and MELD-Na outperformed MELD 3.0 (0.58 [0.48, 0.68], 0.66 [0.55,0.77], 0.67 [0.56, 0.78], and 0.65 [0.53, 0.77]).</p><p><strong>Conclusion: </strong>MELD 3.0 did not outperform its predecessors. MELD-Na may still have a role in assessment of perioperative complications in LT recipients as well as patients with end-stage liver disease undergoing nontransplant operations.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous Heart-Liver Transplant Using Dual-Organ Normothermic Machine Perfusion Following Donation After Circulatory Death: A Case Report.","authors":"Stephanie Y Ohara, Usman Aslam, Lisa M Lemond, David E Steidley, Ayan Sen, Arun L Jayaraman, Channa R Jayasekera, Michele Barnhill, Blanca C Lizaola-Mayo, Kristen A Sell-Dottin, Michelle C Nguyen, Amit K Mathur, Francis X Downey, Kunam S Reddy, Jack W Harbell","doi":"10.1016/j.transproceed.2025.08.018","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.08.018","url":null,"abstract":"<p><p>Combined heart-liver transplantation presents significant challenges, particularly in cases requiring extended ischemic times for managing hemodynamic instability post cardiac implantation. Advances in perfusion techniques, such as the normothermic machine perfusion pump, offer advantages over traditional static cold storage by maintaining organ viability during prolonged periods. We report the first successful combined heart-liver transplant using normothermic machine perfusion for both organs from a donation after circulatory death donor. The recipient is a 45-year-old male with ischemic cardiomyopathy-induced heart failure and end-stage liver disease secondary to congestive hepatopathy. Both organs, procured from a donation after circulatory death donor were preserved on the TransMedics Organ Care System and subsequently transplanted with total post crossclamp times of 7.75 hours for the heart and 15.25 hours for the liver. At 8 months post-transplant, the patient demonstrates stable cardiac and hepatic graft function. This case highlights the critical role of normothermic machine perfusion in optimizing organ quality and mitigating ischemic injury in multi-organ transplants involving donation after circulatory death donors. Our findings support the expanded use of normothermic machine perfusion to enhance organ utilization, particularly in complex, high-risk multi-organ transplants cases.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Mineral Bone Disease Profile in Kidney Transplant Recipients - A 9-Year Retrospective Cohort Study at a Tertiary Center.","authors":"Jun Min Em, Maisarah Jalalonmuhali, Guo Jian Leon, Nur Raziana Rozi, Yee Wan Lee, Soo Kun Lim","doi":"10.1016/j.transproceed.2025.08.024","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.08.024","url":null,"abstract":"<p><strong>Background: </strong>The progression of chronic kidney disease (CKD) into end-stage kidney disease and the eventual kidney transplantation is linked to substantial changes in bone mineral metabolism, predisposing to bone-related complications, including osteoporosis and fractures. Understanding the bone profile in kidney transplant recipients could improve post-transplant care and long-term outcomes.</p><p><strong>Methods: </strong>This retrospective study at the University Malaya Medical Centre (UMMC) involved all kidney transplant recipients from January 2015 to December 2023. Patients without baseline serum intact parathyroid hormone levels or who had graft failure within 1 year were excluded. All baseline characteristics, medications, and pre- and post-transplant bone mineral profiles were collected from electronic medical records (EMRs) and analyzed using Statistical Package for the Social Sciences version 29.0.2.</p><p><strong>Results: </strong>A total of 179 patients were included, with a mean age of 40.6 ± 11.0 years old (57% men). The median dialysis vintage was 18 (interquartile range [IQR] = 36), with 19% undergoing pre-emptive transplants. Before the transplant, 57% of the patients received calcium carbonate, 51.4% were on vitamin D receptor analogues (VDRAs), 26.3% were on sevelamer, 5.6% were on cinacalcet, 2.2% were on lanthanum, and 0.6% were on sucroferric oxyhydroxide. All patients received induction methylprednisolone during the transplant. At 1 year post-transplant, 90% of the patients remained on prednisolone at a median dose of 5.0 mg. Parathyroidectomy was performed on two patients (1.1%) before transplant and another two (1.1%) after transplant. No patient had a fracture post-transplantation during the study period. Biochemically, mean serum intact parathyroid hormone (iPTH), calcium, phosphate, and hemoglobin were significantly improved from pre-transplant to 2 years post-transplant (P < .001), with serum iPTH and calcium showing improvement as early as 3 months and maintained thereafter. Both serum phosphate and hemoglobin levels continuously showed improvement up to 2 years post-transplant (P < .05).</p><p><strong>Conclusions: </strong>Our study showed significant improvements in biochemical bone profile and hemoglobin levels as early as 3 months post-transplant, which had continued to improve or maintain for up to 2 years post-transplant.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Nomogram for Predicting Recurrence of Hepatocellular Carcinoma After Liver Transplantation.","authors":"Ziwen Lu, Yibo Sun, Yifei Wang, Yueyi Sun, Yuanming Qiang, Guangming Li","doi":"10.1016/j.transproceed.2025.07.026","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.07.026","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) remains a critical issue with limited predictive accuracy. We aimed to develop a nomogram integrating clinical indicators, pathological factors, serum tumor markers, and inflammatory markers.</p><p><strong>Methods: </strong>Retrospective data of patients with HCC were collected at Beijing You'an Hospital from January 2015 to December 2022. Univariate and multivariate Cox regression analyses were performed to identify and construct the prognostic nomogram. Receiver operating characteristic (ROC) curves, Kaplan-Meier curves, decision curve analyses, and calibration diagrams were used to assess the predictive capacity of the nomogram.</p><p><strong>Results: </strong>A total of 395 patients with HCC after LT were included in the present study. The nomogram model was established based on seven independent risk factors: LT criteria, hepatic steatosis, microvascular invasion (MVI), Edmondson-Steiner grade, creatinine (Cr), aspartate aminotransferase (AST), and systemic immune-inflammation index (SII). The area under the curve (AUC) for 1 year, 3 years, and 5 years predicting postoperative recurrence-free survival (RFS) was 0.811, 0.826, and 0.828. Decision curve analyses (DCAs) showed excellent clinical utility for the model.</p><p><strong>Conclusions: </strong>We developed a novel, simple, and clinically relevant nomogram for early prediction and diagnosis of post-transplant HCC recurrence.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transplantation with Nonstandard Donor Hearts: Single Center Experience in Central China.","authors":"Qianhai Huang, Junlong Hu, Zhigao Chen, Jizhong Xuan, Jianchao Li, Xiaoliang Qian, Liang Zhao, Qianjin Liu, Zhaoyun Cheng","doi":"10.1016/j.transproceed.2025.08.025","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.08.025","url":null,"abstract":"<p><strong>Background: </strong>Recently, marginal donor hearts have been applied to patients with end-stage heart failure due to rising waiting list mortality and increasing demand for donors. However, the principles of risk prevention and the usage of marginal donor hearts have yet to be clearly defined.</p><p><strong>Methods: </strong>A retrospective analysis was performed to investigate the outcomes of patients undergoing heart transplantation at our center between October 2019 and March 2024. Forty-four patients were enrolled and divided into the marginal donor heart group (n = 30) and the conventional donor heart group (n = 14) according to the classification criteria. The clinical data between the 2 groups were compared and analyzed.</p><p><strong>Results: </strong>There were no statistically significant differences in the postoperative length of hospitalization, ICU stay, left ventricular ejection fraction, or serum biochemical indicators between the 2 groups. Five patients died during the 3-month follow-up period. Notably, 1- and 3- month postoperative follow-up showed no significant differences in left ventricular ejection fraction, serum biochemical indicators, and mortality between the 2 groups CONCLUSION: The application of marginal donor hearts can partially alleviate the shortage of donor heart resources. It did not significantly affect patients' short-term survival or recovery.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Risk Factors of Early Allograft Dysfunction at a Liver Transplantation Center in Brazil: A Retrospective Study.","authors":"Geisiane Custódio, Andrew Maykon Massutti, Sofia Stein Corrêa da Cunha, Cristiane Bauermann Leitão, Tatiana Helena Rech","doi":"10.1016/j.transproceed.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.09.005","url":null,"abstract":"<p><strong>Background: </strong>Early allograft dysfunction (EAD) is a serious complication of liver transplantation. Multiple donor, recipient, and intraoperative risk factors contribute to its development. This study aims to assess the impact of intraoperative risk factors for EAD on clinical outcomes of liver transplant recipients.</p><p><strong>Methods: </strong>This retrospective study enrolled brain-dead donors and adult liver graft recipients. Recipient-donor matching was facilitated via a crossover list, and comprehensive clinical and laboratory data were recorded for donors, recipients, and surgical procedures. The primary outcome assessed was EAD. Secondary outcomes were the association between anatomical variants with bleeding volume and need for blood transfusions, length of ICU and hospital stay, retransplantation, and patient and graft survival after 12 months.</p><p><strong>Results: </strong>A total of 228 patients underwent liver transplants from brain-dead donors between January 2019 and December 2021. The incidence of EAD was 25%. In the univariate analysis, liver graft steatosis, previous abdominal surgery, biliary reconstruction in Roux-in-Y, total transplantation time, bleeding volume, and the need for all types of blood products were associated with EAD. However, after adjustment for the Model for End Stage Liver Disease (MELD) score, only biliary reconstruction in Roux-in-Y (OR 4.58, 95% CI 1.63-12.83, P = .004) and total transplantation time (OR 1.01, 95% CI 1.003-1.014, P = .0002) persisted in association with EAD. Anatomical variants were not associated with EAD, increased bleeding and the need for blood transfusions or other clinical outcomes.</p><p><strong>Conclusions: </strong>Biliary reconstruction in Roux-in-Y and total transplantation time were associated with EAD development while anatomical artery variants were not.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}