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Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis
BACKGROUND AND AIMS: Liver transplantation is the only curative treatment for end-stage liver disease. While waiting list mortality can be predicted by the MELD-score, reliable scoring systems for the postoperative period do not exist. This study's objective was to identify risk factors that co...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4048202/ https://www.ncbi.nlm.nih.gov/pubmed/24905210 http://dx.doi.org/10.1371/journal.pone.0098782 |
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author | Bruns, Helge Lozanovski, Vladimir J. Schultze, Daniel Hillebrand, Norbert Hinz, Ulf Büchler, Markus W. Schemmer, Peter |
author_facet | Bruns, Helge Lozanovski, Vladimir J. Schultze, Daniel Hillebrand, Norbert Hinz, Ulf Büchler, Markus W. Schemmer, Peter |
author_sort | Bruns, Helge |
collection | PubMed |
description | BACKGROUND AND AIMS: Liver transplantation is the only curative treatment for end-stage liver disease. While waiting list mortality can be predicted by the MELD-score, reliable scoring systems for the postoperative period do not exist. This study's objective was to identify risk factors that contribute to postoperative mortality. METHODS: Between December 2006 and March 2011, 429 patients underwent liver transplantation in our department. Risk factors for postoperative mortality in 266 consecutive liver transplantations were identified using univariate and multivariate analyses. Patients who were <18 years, HU-listings, and split-, living related, combined or re-transplantations were excluded from the analysis. The correlation between number of risk factors and mortality was analyzed. RESULTS: A labMELD ≥20, female sex, coronary heart disease, donor risk index >1.5 and donor Na(+)>145 mmol/L were identified to be independent predictive factors for postoperative mortality. With increasing number of these risk-factors, postoperative 90-day and 1-year mortality increased (0–1: 0 and 0%; 2: 2.9 and 17.4%; 3: 5.6 and 16.8%; 4: 22.2 and 33.3%; 5–6: 60.9 and 66.2%). CONCLUSIONS: In this analysis, a simple score was derived that adequately identified patients at risk after liver transplantation. Opening a discussion on the inclusion of these parameters in the process of organ allocation may be a worthwhile venture. |
format | Online Article Text |
id | pubmed-4048202 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-40482022014-06-09 Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis Bruns, Helge Lozanovski, Vladimir J. Schultze, Daniel Hillebrand, Norbert Hinz, Ulf Büchler, Markus W. Schemmer, Peter PLoS One Research Article BACKGROUND AND AIMS: Liver transplantation is the only curative treatment for end-stage liver disease. While waiting list mortality can be predicted by the MELD-score, reliable scoring systems for the postoperative period do not exist. This study's objective was to identify risk factors that contribute to postoperative mortality. METHODS: Between December 2006 and March 2011, 429 patients underwent liver transplantation in our department. Risk factors for postoperative mortality in 266 consecutive liver transplantations were identified using univariate and multivariate analyses. Patients who were <18 years, HU-listings, and split-, living related, combined or re-transplantations were excluded from the analysis. The correlation between number of risk factors and mortality was analyzed. RESULTS: A labMELD ≥20, female sex, coronary heart disease, donor risk index >1.5 and donor Na(+)>145 mmol/L were identified to be independent predictive factors for postoperative mortality. With increasing number of these risk-factors, postoperative 90-day and 1-year mortality increased (0–1: 0 and 0%; 2: 2.9 and 17.4%; 3: 5.6 and 16.8%; 4: 22.2 and 33.3%; 5–6: 60.9 and 66.2%). CONCLUSIONS: In this analysis, a simple score was derived that adequately identified patients at risk after liver transplantation. Opening a discussion on the inclusion of these parameters in the process of organ allocation may be a worthwhile venture. Public Library of Science 2014-06-06 /pmc/articles/PMC4048202/ /pubmed/24905210 http://dx.doi.org/10.1371/journal.pone.0098782 Text en © 2014 Bruns et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Bruns, Helge Lozanovski, Vladimir J. Schultze, Daniel Hillebrand, Norbert Hinz, Ulf Büchler, Markus W. Schemmer, Peter Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis |
title | Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis |
title_full | Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis |
title_fullStr | Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis |
title_full_unstemmed | Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis |
title_short | Prediction of Postoperative Mortality in Liver Transplantation in the Era of MELD-Based Liver Allocation: A Multivariate Analysis |
title_sort | prediction of postoperative mortality in liver transplantation in the era of meld-based liver allocation: a multivariate analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4048202/ https://www.ncbi.nlm.nih.gov/pubmed/24905210 http://dx.doi.org/10.1371/journal.pone.0098782 |
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