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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Dec 18, 2025; 15(4): 110310
Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.110310
Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.110310
Interpreting the hazard zone: Factor V and lactate as critical indicators in severe early allograft injury
Marco Zeppieri, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Marco Zeppieri, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste 34129, Italy
Giovanni Miotti, Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy
Martina Grando, Department of Internal Medicine, Azienda Sanitaria Friuli Occidentale, San Vito al Tagliamento 33070, Italy
Author contributions: Grando M, and Zeppieri M wrote the outline; Grando M, Miotti G and Zeppieri M did the research and writing of the manuscript; Grando M, Miotti G, and Zeppieri M assisted in the writing of the paper; Zeppieri M was responsible for the conception and design of the study and completed the English and scientific editing; Grando M, Miotti G and Zeppieri M assisted in the editing and making critical revisions of the manuscript; all authors provided the final approval of the article.
Conflict-of-interest statement: The author declares no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Zeppieri, MD, PhD, Department of Ophthalmology, University Hospital of Udine, p. le S. Maria della Misericordia 15, Udine 33100, Italy.
Received: June 4, 2025
Revised: June 8, 2025
Accepted: August 1, 2025
Published online: December 18, 2025
Processing time: 168 Days and 13.6 Hours
Revised: June 8, 2025
Accepted: August 1, 2025
Published online: December 18, 2025
Processing time: 168 Days and 13.6 Hours
Core Tip
Core Tip: In liver transplant recipients, quick identification of grafts susceptible to failure continues to be a clinical challenge, especially when aminotransferase levels exceed 5000 U/L during the early postoperative phase. Although generally considered concerning, these increases do not always indicate poor prognosis. For this reason, the use of functional biomarkers, such as serum factor V and arterial lactate levels, is highly considered to more accurately distinguish patients with a greater chance of recovery from those at risk of early transplant failure. Incorporating these elements into daily clinical practice can improve decision making, minimize retransplantations, optimizing patient outcomes and organ preservation.