Clinical outcome of 1,000 consecutive cases of liver transplantation: a single center experience

Kwak, Bong Jun; Kim, Dong Goo; Han, Jae Hyun; Choi, Ho Joong; Bae, Si Hyun; You, Young Kyoung; Choi, Jong Young; Yoon, Seung Kew

doi:10.4174/astr.2018.95.5.267

Cited by 9 publications

(10 citation statements)

References 25 publications

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“…Kusakabe et al (16) found that the three leading causes of death after LT were sepsis, graft failure, and pulmonary complications. Kwak et al (17) reported that the first three causes of death for recipients after LT were infection, recurrence of hepatocellular carcinoma, and graft failure, accounting for 34.8%, 18.3%, and 15.0% of cases, respectively. Different incidences of infection after LT have been reported.…”

Section: Discussionmentioning

confidence: 99%

In-hospital mortality of liver transplantation and risk factors: a single-center experience

Zhang¹,

Fan²,

Wu³

et al. 2021

Ann Transl Med

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Background: Liver transplantation (LT) is a life-saving treatment for patients with end-stage liver disease and acute liver failure. However, in-hospital death cannot be avoided. We designed this study to analyze patients' in-hospital mortality rate after LT and the factors correlated with in-hospital death.Methods: The data of patients who received LT in our hospital between January 11, 2015, and November 19, 2019, were obtained from the China Liver Transplant Registry and medical records. The in-hospital mortality rate was calculated, and factors related to mortality, cause of death, and factors related to cause of death were analyzed by reviewing patients' data.Results: A total of 529 patients who underwent cadaveric LT were enrolled in this study. Modified piggyback orthotopic LT was performed for all patients. Seventy patients died in the hospital after LT, and the in-hospital mortality rate was 13.2%. Factors including model for end-stage liver disease (MELD) score, Child-Pugh grading, intraoperative blood loss, and anhepatic phase were correlated with in-hospital death. MELD score and intraoperative blood loss were determined as the two independent risk factors of in-hospital death. The first two causes of death were infection (34.3%) and primary non-function (15.7%).Pulmonary fungal infection was the main cause of infectious death. MELD score was the independent risk factor for infectious death, and both body mass index of donors and cold ischemic time were independent risk factors of primary non-function.Conclusions: In-hospital death poses a threat to certain patients undergoing LT. Our study suggests that the main cause of in-hospital death is an infection, followed by primary non-function.

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Section: Discussionmentioning

confidence: 99%

In-hospital mortality of liver transplantation and risk factors: a single-center experience

Zhang¹,

Fan²,

Wu³

et al. 2021

Ann Transl Med

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“…Fortunately, postoperative outcomes are gradually improving because of development of surgical skills, medical treatment, and supporting resources. Recent study showed 74.7% patient survival at 5-year in 1,000 cases of LT in single center [1].…”

Section: Introductionmentioning

confidence: 98%

Tenofovir does not induce renal dysfunction compared to entecavir in post-liver-transplant hepatitis B virus patients

et al. 2020

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Tenofovir disoproxil fumarate is accepted as an effective and tolerable drug for treatment of HBV, similar to entecavir. However, there are some concerns about the nephrotoxicity of tenofovir. The aim of this study is to compare the renal-function change of liver recipients who received tenofovir or entecavir for HBV. Methods: Among 468 patients with HBV who underwent liver transplantation at Samsung Medical Center between January 2008 and December 2015, the patients treated with tenofovir (n = 39) or entecavir (n = 429) were reviewed retrospectively. Baseline characteristics and renal-function change after 1 month, 1 year, and 2 years were compared. Propensity-score matching was performed for 37 patients using tenofovir and 132 patients using entecavir. We also analyzed risk factors of renal dysfunction. Results: Age, preoperative creatinine, estimated glomerular filtration rate (e-GFR), and hepatic encephalopathy score showed statistical difference between the tenofovir and entecavir groups. The proportion of patients with 'decreased renal function (e-GFR < 60 mL/min/1.73 m 2)' was higher in the tenofovir group than in the entecavir group (33.3% vs. 12.4% at postoperative one year, P < 0.005). After propensity-score matching, there was no statistical difference in preoperative characteristics. Postoperative 1-, 2-, and 3-year e-GFR and creatinine showed no statistical difference in either group. On multivariate analysis, only preoperative high e-GFR showed a protective effect on renal-function change (odds ratio, 0.97; P < 0.001), and there was no aggravating factor. Conclusion: Tenofovir disoproxil fumarate does not induce renal dysfunction in liver-transplanted patients with HBV more than does entecavir.

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“…Due to the absolute shortage of brain-dead organ donors, the opportunity arises only in critically ill patients with a MELD score of 40 or more. Currently, the number of brain-dead organ donors per million in South Korea is 8.68, which is very low compared to 48.9 in Spain and 36.88 in the United States [ 15 16 ]. This serious shortage of brain-dead donors appeared to be a phenomenon in which patients with high severity were mainly selected for DDLT after the introduction of the MELD system [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of Model for End-Stage Liver Disease score on deceased donor liver transplant outcomes in low volume liver transplantation center: a retrospective and single-center study

et al. 2021

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Purpose In June 2016, the Model for End-Stage Liver Disease (MELD) score was employed in South Korea instead of the Child-Turcotte-Pugh (CTP) score. This study compared the outcomes of deceased donor liver transplantation (DDLT) before and after the MELD system application. Methods This retrospective study reviewed 48 patients who underwent DDLT for end-stage liver disease at a single tertiary referral center between January 2014 and December 2018. The patients were categorized into the pre-MELD (22 patients) and post-MELD (26 patients) groups. The demographics, postoperative outcomes, and overall survival time were evaluated between the 2 groups. Results The 2 groups had no differences in age, sex, ABO type, etiology for liver transplantation, CTP-score, operation time, cold ischemic time, and amount of red blood cell transfusion, although their MELD score differed significantly (post-MELD group, 36.2 ± 4.9; pre-MELD group, 27.7 ± 11.8; P < 0.001). The post-MELD group has longer intensive care unit stay (11.2 ± 9.5 days vs. 5.7 ± 4.5 days, P = 0.018) and hospital stay than the pre-MELD group (36.8 ± 26 days vs. 22.8 ± 9.3 days, P = 0.016). The 1-year survival rate was lower in the post-MELD group (61.5% vs. 86.4%, P = 0.029). Conclusion After MELD allocation, patients with high MELD scores had increased DDLT and consequently required a longer recovery time, which could negatively affect survival. According to the experience of a small-volume center, these problems were related to both severe organ shortages in South Korea and MELD allocation.

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Clinical outcome of 1,000 consecutive cases of liver transplantation: a single center experience

Cited by 9 publications

References 25 publications

In-hospital mortality of liver transplantation and risk factors: a single-center experience

In-hospital mortality of liver transplantation and risk factors: a single-center experience

Tenofovir does not induce renal dysfunction compared to entecavir in post-liver-transplant hepatitis B virus patients

The impact of Model for End-Stage Liver Disease score on deceased donor liver transplant outcomes in low volume liver transplantation center: a retrospective and single-center study

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