Correlation Between Selected Prognostic Factors and Postoperative Course in Liver Transplant Recipients

Patkowski, Waldemar; Zieniewicz, Krzysztof; Skalski, Michał; Krawczyk, Marek

doi:10.1016/j.transproceed.2009.09.038

Cited by 19 publications

(15 citation statements)

References 47 publications

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“…Concerning the alcoholic etiology of liver disease, it is worth noticing that some authors have raised the question of cirrhotic patients due to alcoholism having a better outcome without transplantation than cirrhotics due to viral hepatitis (2) , and others have found that alcoholic patients had more post-transplant complications (30) . Both these remarks could reinforce that the reported trend in listing and transplanting less alcoholic patients might be positive to the system as a whole.…”

Section: Discussionmentioning

confidence: 99%

“…Patients were consecutively enrolled and divided into two groups, one including the cases enlisted from January 2004 to December 2004, representing the pre-MELD group, in which time in list was the criterion for receiving an organ, and the other including those enlisted from June 2006 to December 2007, representing the post-MELD group, when the severity of the cases, determined by the MELD score (22,24) , became the condition used to allocate the livers (30) . Patients studied were listed by all 4 major liver transplantation teams of the State.…”

Section: Methodsmentioning

confidence: 99%

“…In the first year of the MELD-based allocation system in the USA, there seemed to be a reduction of mortality in the wait-list, without decreasing receptors' survival (14) . On the other hand, many authors have found that candidates with higher MELD scores had worse survival when transplanted (5,14,20,28,30,31,34,37,39) . Actually, it is not clear if transplanting more severely ill patients impacts negatively in post-transplant survival (7,13) .…”

Section: Analysis Of the Survival Of Cirrhotic Patients Enlisted For mentioning

confidence: 99%

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Analysis of the Survival of Cirrhotic Patients Enlisted for Liver Transplantation in the Pre- And Post-Meld Era in Southern Brazil

Mattos

Sacco

Hoppe

et al. 2014

Arq. Gastroenterol.

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-Context -Transplantation is the only cure for decompensated cirrhosis. Model for End-Stage Liver Disease (MELD) is used in liver allocation. Objectives -Comparing survival of enlisted populations in pre-and post-MELD eras and estimating their long-term survival. Methods -This is a retrospective study of cirrhotics enlisted for transplantation during pre-and post-MELD eras. Survival curves were generated using Kaplan-Meier's model. Cox's model was used to determine risk factors for mortality. Exponential, Weibull's, normal-log and Gompertz's models were used to estimate long-term survival. Results -The study included 162 patients enlisted in pre-MELD era and 184 in post-MELD period. Kaplan-Meier's survival curve of patients enlisted in post-MELD era was better than that of pre-MELD period (P = 0.009). This difference remained for long-term estimates, with a survival of 53.54% in 5 years and 44.64% in 10 years for patients enlisted in post-MELD era and of 43.17% and 41.75% for pre-MELD period. Era in which patients had been enlisted (P = 0.010) and MELD score at enlistment (P<0.001) were independently associated to survival with hazard ratios of 0.664 (95% CI-confidence interval = 0.487-0.906) and 1.069 (95% CI = 1.043-1.095). Conclusion -MELDbased transplantation policy is superior to chronology-based one, promoting better survival for enlisted patients, even in long-term.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Analysis Of the Survival Of Cirrhotic Patients Enlisted For mentioning

confidence: 99%

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Analysis of the Survival of Cirrhotic Patients Enlisted for Liver Transplantation in the Pre- And Post-Meld Era in Southern Brazil

Mattos

Sacco

Hoppe

et al. 2014

Arq. Gastroenterol.

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“…Additional nonimmune factors that affect graft survival include age of the recipient, length of time without blood for the graft, infection with cytomegalovirus and toxicity of the immunosuppressants, all of which can cause degradation of the allograft and chronic rejection [14]. In addition, a recent study suggests that the original cause of the damaged liver also influences the outcome of the graft [18]. Immune destruction is thought to target the small arterial intima and smooth muscle of the liver and induce hyperplasia.…”

Section: Discussionmentioning

confidence: 99%

Establishment of a Chronic Rejection Model for Orthotopic Liver Transplantation in the Rat

Huang²,

Liu³

2011

Eur Surg Res

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Background: This study aims to establish a stable chronic rejection model for orthotopic liver transplantation in the rat and to describe the pathological features of this model. Methods: The livers from different strains of rats were transplanted in various allogeneic donor-recipient combinations with appropriate syngeneic grafts used as controls. The rats were untreated after surgery (acute rejection model) or treated with cyclosporin A (1 mg/kg) and hydrocortisone (0.75 mg/kg) to establish chronic rejection as determined by rejection activity index scores from pathological examination of liver specimens. Results: Acute rejection occurred in all of the untreated recipients of allogeneic orthotopic liver transplants, and all died within 30 days. Among the treated recipients, the combinations of Lewis with brown Norway and dark agouti with Lewis rats developed acute rejection, and no changes characteristic of chronic rejection were observed in the few rats that survived beyond 30 days. In contrast, the treated Lewis recipients of livers from Sprague-Dawley rats exhibited chronic rejection in the liver specimens. Conclusion: We have established an animal model for chronic rejection after transplantation of livers from Sprague-Dawley to Lewis rats under short-term immunosuppression induced by small doses of cyclosporin A and hydrocortisone.

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“…The most useful predictive factors for 1-year survival were urea/ creatinine and liver function tests. (Patkowski et al, 2009). In addition, transplantation of a liver with >25% steatosis was a risk factor for the development of a biliary complication (Baccarani et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

The Liver Biopsy During Organ Procurement

Fries¹

2011

Liver Biopsy in Modern Medicine

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Correlation Between Selected Prognostic Factors and Postoperative Course in Liver Transplant Recipients

Cited by 19 publications

References 47 publications

Analysis of the Survival of Cirrhotic Patients Enlisted for Liver Transplantation in the Pre- And Post-Meld Era in Southern Brazil

Analysis of the Survival of Cirrhotic Patients Enlisted for Liver Transplantation in the Pre- And Post-Meld Era in Southern Brazil

Establishment of a Chronic Rejection Model for Orthotopic Liver Transplantation in the Rat

The Liver Biopsy During Organ Procurement

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