Living donor liver transplantation in high Model for End‐Stage Liver Disease score patients

Feng, Sandy

doi:10.1002/lt.24819

Cited by 16 publications

(18 citation statements)

References 54 publications

(110 reference statements)

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“…Living donor liver transplantation (LDLT) has been widely accepted as one of the definitive treatments for patients with end-stage liver disease (ESLD) [1]. The patient and graft survival rates of LDLT and deceased donor liver transplantation (DDLT) are comparable [2].…”

Section: Introductionmentioning

confidence: 99%

Predictive utility of the C-reactive protein to albumin ratio in early allograft dysfunction in living donor liver transplantation: A retrospective observational cohort study

et al. 2019

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BackgroundThis study was performed to determine the association between the ratio of C-reactive protein to albumin (CRP/ALB) and the risk of early allograft dysfunction (EAD) in patients undergoing living donor liver transplantation (LDLT).Patients and methodsA total of 588 adult patients undergoing LDLT were retrospectively investigated, after 22 were excluded because of signs of overt infection or history of ALB infusion. The study population was classified into high and low CRP/ALB ratio groups according to EAD. All laboratory variables, including CRP and ALB, had been collected on the day before surgery. A percentage value for the CRP/ALB ratio (%) was calculated as CRP/ALB × 100.ResultsAfter LDLT, 83 patients (14.1%) suffered EAD occurrence. A higher CRP/ALB ratio was independently associated with risk of EAD, Model for End-stage Liver Disease score, fresh frozen plasma transfusion, and donor age. Based on a cutoff CRP/ALB ratio (i.e., > 20%), the probability of EAD was significantly (2-fold) higher in the high versus low CRP/ALB group. The predictive utility of CRP/ALB ratio for EAD was greater than those of other inflammatory markers. In addition, patients with a high CRP/ALB ratio had poorer survival than those with a low CRP/ALB ratio during the follow-up period.ConclusionsThe easily calculated CRP/ALB ratio may allow estimation of the risk of EAD after LDLT and can provide additional information that may facilitate the estimation of a patient’s overall condition.

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Section: Introductionmentioning

confidence: 99%

Predictive utility of the C-reactive protein to albumin ratio in early allograft dysfunction in living donor liver transplantation: A retrospective observational cohort study

et al. 2019

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“…Demographic data for each patient was collected, including age, gender, BMI, diagnosis, American society of anesthesiologists classification (ASA) [21], and laboratory tests (blood tests, liver and kidney function tests, and coagulation function tests). In addition, liver function for the cirrhotic patients was graded using the Child-Pugh classification [22] and Model for End-stage Liver Disease (MELD) score [23]. Further, a revaluation of Child-Pugh class was performed after biliary drainage.…”

Section: Preoperative Assessmentmentioning

confidence: 99%

Safety of laparoscopic pancreaticoduodenectomy in patients with liver cirrhosis using propensity score matching

et al. 2021

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Currently, safety of laparoscopic pancreaticoduodenectomy (LPD) in patients with liver cirrhosis is unknown. The aim of this study was to explore postoperative morbidity and mortality and long-term outcomes of cirrhotic patients after LPD. The study was a one-center retrospective study comprising 353 patients who underwent LPD between October 2010 and December 2019. A total of 28 patients had liver cirrhosis and were paired with 56 non-cirrhotic counterparts through propensity score matching (PSM). Baseline data, intra-operative data, postoperative data, and survival data were collected. Postoperative morbidity was considered as primary outcome whereas postoperative mortality, surgical parameters (operative durations, intraoperative blood loss), and long-term overall survival were secondary outcomes. Cirrhotic patients showed postoperative complication rates of 82% compared with rates of patients in the control group (48%) (P = 0.003). Further, Clavien-Dindo ≥III complication rates of 14% and 11% (P = 0.634), Clavien-Dindo I-II complication rates of 68% and 38% (P = 0.009), hospital mortality of 4% and 2% (P = 0.613) were observed for cirrhotic patients and non-cirrhotic patients, respectively. In addition, an overall survival rate of 32 months and 34.5 months (P = 0.991), intraoperative blood loss of 300 (200–400) ml and 150 (100–250) ml (P<0.0001), drain amount of 2572.5 (1023.8–5275) ml and 1617.5 (907.5–2700) ml (P = 0.048) were observed in the cirrhotic group and control group, respectively. In conclusion, LPD is associated with increased risk of postoperative morbidity in patients with liver cirrhosis. However, the incidence of Clavien-Dindo ≥III complications and post-operative mortality showed no significant increase. In addition, liver cirrhosis showed no correlation with poor overall survival in patients who underwent LPD. These findings imply that liver cirrhosis patients can routinely be considered for LPD at high volume centers with rigorous selection and management.

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“…Living donor liver transplantation (LDLT) is a widely performed operation for patients with end-stage liver disease [ 1 ]. However, various postoperative complications can occur, and mortality is higher in such patients [ 2 ] Therefore, early identification of relevant risk factors and proper management are crucial for a good prognosis.…”

Section: Introductionmentioning

confidence: 99%

Predictive utility of fibrinogen in acute kidney injury in living donor liver transplantation: A propensity score-matching analysis

et al. 2021

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Background This study investigated the association between the fibrinogen level and the risk of acute kidney injury (AKI) in patients who have undergone living donor liver transplantation (LDLT). Patients and methods A total of 676 patients who underwent LDLT were analyzed retrospectively. Exclusion criteria included a history of severe kidney dysfunction, emergency operation, deceased donor, ABO-incompatible transplantation, and missing data. The study population was divided into low and normal fibrinogen groups. A 1:1 propensity score (PS) matching analysis was used to evaluate the association between a low fibrinogen level (< 160 mg/dL) and postoperative development of AKI. Results In total, 142 patients (23.1%) developed AKI after LDLT. The PS matching analysis showed that the probability of AKI was two-fold higher in the low fibrinogen group than in the normal fibrinogen group. In addition, patients with AKI had poorer postoperative outcomes such as longer hospitalization, longer ICU stay, and higher mortality than patients without AKI. Conclusions The preoperative fibrinogen level may be useful for risk stratification of patients undergoing LDLT in terms postoperative development of AKI.

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Living donor liver transplantation in high Model for End‐Stage Liver Disease score patients

Cited by 16 publications

References 54 publications

Predictive utility of the C-reactive protein to albumin ratio in early allograft dysfunction in living donor liver transplantation: A retrospective observational cohort study

Predictive utility of the C-reactive protein to albumin ratio in early allograft dysfunction in living donor liver transplantation: A retrospective observational cohort study

Safety of laparoscopic pancreaticoduodenectomy in patients with liver cirrhosis using propensity score matching

Predictive utility of fibrinogen in acute kidney injury in living donor liver transplantation: A propensity score-matching analysis

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