Serum factor V and arterial lactate levels predict graft survival in liver transplant recipients with aminotransferase above five thousand

Table 1 Baseline characteristics of adult liver transplantation patients with aminotransferase > 5000 U/L, n (%)

Number	25
Age (years), median (IQR)	54 (45-60)
Male sex	13 (52)
Etiology of liver disease
Hepatitis C virus	14 (56)
Hepatitis B virus	2 (8)
Alcohol	2 (8)
Biliary	2 (8)
Acute liver failure	2 (8)
Polycystic liver disease	1 (4)
Metabolic-dysfunction-associated fatty liver disease	1 (4)
Autoimmune hepatitis	1 (4)
Child-Pugh-Turcotte classification
A	9 (36)
B	9 (36)
C	7 (28)
Model for end stage liver disease-Na, median (IQR)	13 (10-17)
Aspartate aminotransferase	8053 (6730-11340)
Alanine aminotransferase	4135 (2980-6414)
Serum factor V	28 (14-46)
Arterial lactate	4.4 (2.6-11.6)

IQR: Interquartile range.

Table 2 Performance of predictors of early allograft failure on postoperative day 1

Predictor	Area under the curve	Cutoff	Sensitivity	Specificity	Negative predictive value	Positive predictive value
Factor V	0.936	26.2%	90	92.8	92.8	90
Lactate	0.919	9 mmol/L	81.8	92.8	86.7	90
Bilirubin	0.672	4.4 mg/dL	45	92.8	68.4	83.3
International normalized ratio	0.825	2.7	90.1	64.3	90	66.7
Laboratory model for end stage liver disease	0.870	27	81.8	78.6	84.6	75
Aspartate aminotransferase	0.669	6947 U/L	90.1	57.1	88.9	62.5
Alanine aminotranferase	0.575	7235 U/L	36.4	100	66.7	100

Table 3 Laboratory parameters, outcome and most likely cause of peak aminotransferase of each patient

Peak aspartate aminotransferase (U/L)	Peak alanine aminotransferase (U/L)	Factor V POD 1	Lactate POD 1	Early allograft failure	Most likely cause of peak aminotransferase > 5000 U/L
14256	4440	33.9	2.3	No	Long cold ischemia time (540 minutes) and warm ischemia time (56 minutes)
6491	2980	27.3	4.1	No	Arterio-portal fistula secondary to core needle biopsy of the allograft
7763	4479	67.9	2.58	No	Intraoperative and/or postoperative bleeding
8511	5545	14.6	8.9	No	Intraoperative and/or postoperative bleeding
8053	3030	46.3	4.4	No	Unclear/liver with ischemic areas at relaparotomy
5151	1736	35.6	11.5	No	Intraoperative and/or postoperative bleeding
5415	4135	27.6	1.41	No	Unclear
6730	2740	46.3	5.8	No	Long warm ischemia time (60 minutes)
5138	2661	35.8	1.6	No	Biopsy-proven graft steatosis
11340	5188	28.5	1.96	No	Low initial portal inflow
10120	6860	57.4	3.5	No	Right hepatic vein thrombosis causes ischemia in right posterior liver section
6166	3568	66	1.1	No	Long cold ischemia time (645 minutes)
6450	2830	54	1.2	No	Severe postoperative hemodynamic instability
13394	6414	63.2	3.7	No	Abdominal compartment syndrome due to large-for-size-graft
10995	8971	Not applicable	11.1	Yes	Primary nonfunction
7164	4135	10	17.4	Yes	Primary nonfunction
10390	1655	9.9	18.1	Yes	Intraoperative and/or postoperative bleeding
27840	10320	37.5	3.61	Yes	Abdominal compartment syndrome due to large-for-size-graft
12628	8166	17	14.8	Yes	Intraoperative and/or postoperative bleeding
8276	3997	6.8	14.7	Yes	Primary nonfunction
7543	3355	13.3	11.6	Yes	Primary nonfunction
13900	6589	3.7	16	Yes	Primary nonfunction
7857	4217	13	9.2	Yes	Primary nonfunction
7708	2681	25.2	4.1	Yes	Intraoperative and/or postoperative bleeding
15115	7610	14.2	18	Yes	Intraoperative and/or postoperative bleeding

POD: postoperative day.