Predicting survival after living and deceased donor liver transplantation in adult patients with acute liver failure View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-04-18

AUTHORS

Young-Joo Jin, Young-Suk Lim, Seungbong Han, Han Chu Lee, Shin Hwang, Sung Gyu Lee

ABSTRACT

BackgroundPost-transplant outcomes for acute liver failure (ALF) are unsatisfactory, and there are debates about the most suitable type of graft. Given the critical shortage of donor organs, accurate assessment of post-transplant outcome in ALF patients is crucial to avoid a futile liver transplantation (LT).MethodsA database of 160 consecutive adult ALF patients who underwent primary LT between 2000 and 2009 in a tertiary LT center was analyzed.ResultsThe most common causes of ALF were hepatitis B virus infection (30%) and herbal/folk medicine use (30%). Thirty-six (22.5%) and 124 (77.5%) patients underwent deceased-donor LT (DDLT) and adult-to-adult living-donor LT (LDLT), respectively. During a median follow-up period of 38 (range 1–132) months, the DDLT and LDLT groups showed similar patient (P = 0.99) and graft (P = 0.97) survival rates. The overall 1- and 3-year patient survival rates were 78.8 and 74.6%, respectively. Five predictors of patient survival were identified by bootstrapping and multivariate analysis: vasopressor requirement, estimated glomerular filtration rate, serum sodium concentration, recipient age, and donor age, at the time of transplant. By summing scores weighted in each of these predictor categories, we designed a prognostic scoring system (scores from −2 to 20) that estimated 1-year post-transplant mortality from 0 to 100% (c statistic 0.79).ConclusionsLong-term outcomes after LDLT and DDLT were comparable in adult patients with ALF. A simple prognostic scoring system that includes 5 predictive variables at the time of LT may help estimate post-transplant survival in ALF patients, regardless of the type of transplant. More... »

PAGES

1115-1124

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00535-012-0570-7

DOI

http://dx.doi.org/10.1007/s00535-012-0570-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1007398036

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22526269


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