The Journal of surgical research · 2026
Perioperative Dextran-40 Infusion and Early Allograft Outcomes After Adult Liver Transplantation: An Overlap-Weighted Cohort Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Raykateeraroj Nattaya, Lee Dong-Kyu, Albert Suh Je Min, Kitisin Nuanprae, Dewapura Suwandi, Caragata Rebecca, Freeman Thomas, Botta Harry, Yin Zoe, Flinkier Ariane, Tran Nghiep, Karalapillai Dharshi, Fischer Caleb, Perini Marcos, Fink Michael, Weinberg Laurence
Аннотация
INTRODUCTION: Dextran-40 has rheological and antithrombotic effects that could modulate early allograft injury, but contemporary evidence in adults is limited. We evaluated whether early postoperative dextran-40 use was associated with improved graft outcomes.
METHODS: In this single-center retrospective cohort, we studied 900 adult liver transplant recipients (2009-2023) using a 48-h landmark to reduce immortal-time bias; 883 patients alive with their primary graft at 48 h formed the analytic cohort. Early exposure was defined as starting dextran-40 within 48 h after transplantation versus later or no dextran. Confounding was addressed with propensity score overlap weighting. Primary outcomes were primary nonfunction, early allograft dysfunction, and 30-day graft loss.
RESULTS: In the overlap-weighted analyses, early dextran-40 was associated with lower 30-day graft loss (2.0% versus 7.6%; risk difference -5.6 percentage points, 95% confidence interval -10.5 to -0.7). Rates of primary nonfunction, early allograft dysfunction, mortality, thrombotic events, acute kidney injury, and reoperation for bleeding did not differ meaningfully between groups.
CONCLUSIONS: In this contemporary cohort, early dextran-40 administration was associated with better short-term graft survival without evidence of safety concerns. These observational findings warrant confirmation in prospective multicenter trials.
METHODS: In this single-center retrospective cohort, we studied 900 adult liver transplant recipients (2009-2023) using a 48-h landmark to reduce immortal-time bias; 883 patients alive with their primary graft at 48 h formed the analytic cohort. Early exposure was defined as starting dextran-40 within 48 h after transplantation versus later or no dextran. Confounding was addressed with propensity score overlap weighting. Primary outcomes were primary nonfunction, early allograft dysfunction, and 30-day graft loss.
RESULTS: In the overlap-weighted analyses, early dextran-40 was associated with lower 30-day graft loss (2.0% versus 7.6%; risk difference -5.6 percentage points, 95% confidence interval -10.5 to -0.7). Rates of primary nonfunction, early allograft dysfunction, mortality, thrombotic events, acute kidney injury, and reoperation for bleeding did not differ meaningfully between groups.
CONCLUSIONS: In this contemporary cohort, early dextran-40 administration was associated with better short-term graft survival without evidence of safety concerns. These observational findings warrant confirmation in prospective multicenter trials.