Ninety liver transplantations were performed in 81 patients. Plasma endotoxin was measured preoperatively, at the end of the anhepatic phase, and on postoperative days 1, 3, and 7. The presence of high endotoxin levels preoperatively and at the end of the anhepatic period was associated with graft failure and a high mortality. Patients with primary nonfunction of their transplants typically had severe endotoxemia. Endotoxemia could be a cause rather than an effect of perioperative complications and graft loss
