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Predictors of early recipient mortality after living donor liver transplantation in a tertiary care center in Egypt
BACKGROUND: Living donor liver transplantation (LDLT) has evolved into a widely accepted therapeutic option. Many different risk factors may affect early mortality after LDLT. OBJECTIVES: Analyze risk factors that can affect early (<6 months) mortality of patients after LDLT in a single center. D...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
King Faisal Specialist Hospital and Research Centre
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832315/ https://www.ncbi.nlm.nih.gov/pubmed/31580715 http://dx.doi.org/10.5144/0256-4947.2019.337 |
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author | Nafea, Mohammed A. Alsebaey, Ayman Abd El Aal Sultan, Ahmed Goda, Mohammed Hisham Salman, Ahmed Rashed, Hanaa Said Soliman, Ahmed Elshenoufy, Mai Abdelrahman, Mostafa |
author_facet | Nafea, Mohammed A. Alsebaey, Ayman Abd El Aal Sultan, Ahmed Goda, Mohammed Hisham Salman, Ahmed Rashed, Hanaa Said Soliman, Ahmed Elshenoufy, Mai Abdelrahman, Mostafa |
author_sort | Nafea, Mohammed A. |
collection | PubMed |
description | BACKGROUND: Living donor liver transplantation (LDLT) has evolved into a widely accepted therapeutic option. Many different risk factors may affect early mortality after LDLT. OBJECTIVES: Analyze risk factors that can affect early (<6 months) mortality of patients after LDLT in a single center. DESIGN: Retrospective chart review of patients who underwent LDLT. SETTING: University hospital. PATIENTS AND METHODS: Adult cirrhotic patients who underwent LDLT were classified by early (first 6 months) or late mortality. A full pre, intra- and post-operative evaluation had been done on all patients including a full history, examination and investigations to identify risk factors that might affect mortality post-LDLT. MAIN OUTCOME MEASURES: Determination of pre-, intra- or postoperative factors that might affect recipient mortality post-LDLT. SAMPLE SIZE: 123. RESULTS: Pre-operative factors that increased early mortality in a univariate analysis were higher model for end-stage liver disease (MELD) scores, lower graft-recipient weigh ratio (GRWR), older donor age, and recurrent spontaneous bacterial peritonitis. Intraoperative factors included more transfusion units of blood, plasma, platelets and cryoprecipitate, a longer time for cold and warm ischemia, and a longer anhepatic phase among others. Postoperative factors included a longer ICU or hospital stay and abnormal postoperative laboratory data. In the final logistic regression model, the most significant factors were pre-operative GRWR, length of hospital stay, units of intraoperative blood transfusion, postoperative alanine aminotransferase, postoperative total leukocyte count, and MELD score. CONCLUSION: LDLT outcomes might be improved by attempting to resolve clinical factors that have been identified as contributors to early post-LDLT mortality. LIMITATIONS: More risk factors, such as those relevant to patient portal vein hemodynamics, should be included in an analysis of predictors of early mortality. CONFLICT OF INTEREST: None. |
format | Online Article Text |
id | pubmed-6832315 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | King Faisal Specialist Hospital and Research Centre |
record_format | MEDLINE/PubMed |
spelling | pubmed-68323152019-11-21 Predictors of early recipient mortality after living donor liver transplantation in a tertiary care center in Egypt Nafea, Mohammed A. Alsebaey, Ayman Abd El Aal Sultan, Ahmed Goda, Mohammed Hisham Salman, Ahmed Rashed, Hanaa Said Soliman, Ahmed Elshenoufy, Mai Abdelrahman, Mostafa Ann Saudi Med Original Article BACKGROUND: Living donor liver transplantation (LDLT) has evolved into a widely accepted therapeutic option. Many different risk factors may affect early mortality after LDLT. OBJECTIVES: Analyze risk factors that can affect early (<6 months) mortality of patients after LDLT in a single center. DESIGN: Retrospective chart review of patients who underwent LDLT. SETTING: University hospital. PATIENTS AND METHODS: Adult cirrhotic patients who underwent LDLT were classified by early (first 6 months) or late mortality. A full pre, intra- and post-operative evaluation had been done on all patients including a full history, examination and investigations to identify risk factors that might affect mortality post-LDLT. MAIN OUTCOME MEASURES: Determination of pre-, intra- or postoperative factors that might affect recipient mortality post-LDLT. SAMPLE SIZE: 123. RESULTS: Pre-operative factors that increased early mortality in a univariate analysis were higher model for end-stage liver disease (MELD) scores, lower graft-recipient weigh ratio (GRWR), older donor age, and recurrent spontaneous bacterial peritonitis. Intraoperative factors included more transfusion units of blood, plasma, platelets and cryoprecipitate, a longer time for cold and warm ischemia, and a longer anhepatic phase among others. Postoperative factors included a longer ICU or hospital stay and abnormal postoperative laboratory data. In the final logistic regression model, the most significant factors were pre-operative GRWR, length of hospital stay, units of intraoperative blood transfusion, postoperative alanine aminotransferase, postoperative total leukocyte count, and MELD score. CONCLUSION: LDLT outcomes might be improved by attempting to resolve clinical factors that have been identified as contributors to early post-LDLT mortality. LIMITATIONS: More risk factors, such as those relevant to patient portal vein hemodynamics, should be included in an analysis of predictors of early mortality. CONFLICT OF INTEREST: None. King Faisal Specialist Hospital and Research Centre 2019-10 2019-10-03 /pmc/articles/PMC6832315/ /pubmed/31580715 http://dx.doi.org/10.5144/0256-4947.2019.337 Text en Copyright © 2019, Annals of Saudi Medicine, Saudi Arabia This is an open access article under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). The details of which can be accessed at http://creativecommons.org/licenses/by-nc-nd/4.0/ |
spellingShingle | Original Article Nafea, Mohammed A. Alsebaey, Ayman Abd El Aal Sultan, Ahmed Goda, Mohammed Hisham Salman, Ahmed Rashed, Hanaa Said Soliman, Ahmed Elshenoufy, Mai Abdelrahman, Mostafa Predictors of early recipient mortality after living donor liver transplantation in a tertiary care center in Egypt |
title | Predictors of early recipient mortality after living donor liver transplantation in a tertiary care center in Egypt |
title_full | Predictors of early recipient mortality after living donor liver transplantation in a tertiary care center in Egypt |
title_fullStr | Predictors of early recipient mortality after living donor liver transplantation in a tertiary care center in Egypt |
title_full_unstemmed | Predictors of early recipient mortality after living donor liver transplantation in a tertiary care center in Egypt |
title_short | Predictors of early recipient mortality after living donor liver transplantation in a tertiary care center in Egypt |
title_sort | predictors of early recipient mortality after living donor liver transplantation in a tertiary care center in egypt |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832315/ https://www.ncbi.nlm.nih.gov/pubmed/31580715 http://dx.doi.org/10.5144/0256-4947.2019.337 |
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