Prognosis and life expectancy in chronic liver disease

Propst, A; Propst, Theresa; Zangerl, G.; Öfner, Dietmar; Judmaier, G; Vogel, Wolfgang

doi:10.1007/bf02212706

Cited by 111 publications

(62 citation statements)

References 38 publications

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“…In patients awaiting primary OLT, CPT score was reported to be a predictor of mortality. 6 Similarly, in our patients who underwent re-OLT, there was a trend to increasing mortality with increasing CPT scores. Recent studies have shown that recipient age and preoperative creatinine and bilirubin levels are constant predictors of mortality after re-OLT.…”

Section: Discussionsupporting

confidence: 54%

Retransplantation for late liver graft failure: Predictors of mortality

et al. 2000

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As patient survival after orthotopic liver transplantation (OLT) improves, late complications, including late graft failure, more commonly occur and retransplantation (re-OLT) is required more often. Survival after re-OLT is poorer than after primary OLT, and given the organ shortage, it is essential that we optimize our use of scarce donor livers. We sought to identify variables that predict poor outcome after late re-OLT. Among adults who underwent OLT between September 1989 and October 1997, we identified transplant recipients who survived greater than 6 months (n ‫؍‬ 964) and analyzed those who required late re-OLT (H6 months after primary OLT). We recorded the indication for the initial OLT and interval from OLT to re-OLT. We also analyzed data collected at the time of re-OLT, including age, sex, indications for primary OLT and re-OLT, United Network for Organ Sharing status, preoperative laboratory values (white blood cells, platelets, hemoglobin, albumin, bilirubin, creatinine, and prothrombin time), Child-PughTurcotte score, number of rejection episodes before re-OLT, and interval between OLT and re-OLT. In addition, we analyzed surgical factors (including procedure performed and use of packed red blood cells, fresh frozen plasma, and platelets), postoperative immunosuppression, and donor factors (age, ischemic time). Forty-eight patients (5%) underwent late re-OLT at a median of 557 days (range, 195 to 2,559 days) post-OLT. Survival rates after re-OLT at 90 days, 1 year, and 5 years were 71%, 60%, and 42%, respectively. Patients surviving 90 days or greater after re-OLT had an 85% chance of surviving to 1 year. Sepsis was the leading cause of death (15 of 25 deaths; 60%). Recipient age older than 50 years (P ‫؍‬ .04), preoperative creatinine level greater than 2 mg/dL (P ‫؍‬ .004), and use of intraoperative blood products (packed red blood cells, P ‫؍‬ .001; fresh frozen plasma, P ‫؍‬ .002; platelets, P ‫؍‬ .004) had significant impacts on survival. Late re-OLT was associated with increased mortality. Careful patient selection, with particular attention to recipient age and renal function, may help improve results and optimize our use of scarce donor livers.

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Section: Discussionsupporting

confidence: 54%

Retransplantation for late liver graft failure: Predictors of mortality

et al. 2000

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“…Gastric ulcer was found increasingly with greater age, while, cirrhosis was found to decline with age. Cirrhosis possibly had decreased prevalence with age because cirrhotic patients have shorter life expectancy [19]. Esophageal-caused UGIB prevalence was significantly different in each age group, but this may be not be clinically important.…”

Section: Discussionmentioning

confidence: 94%

Epidemiology of upper gastrointestinal bleeding and Helicobacter pylori infection: review of 3,488 Thai patients

et al. 2015

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Background:The current epidemiology of upper gastrointestinal bleeding (UGIB) in Thailand is poorly understood and the reported prevalence of Helicobacter pylori infection is outdated. Objectives: To investigate the etiologies of UGIB and prevalence of H. pylori infection in Thailand, including its association with UGIB. Methods: We retrieved information regarding patients attending the endoscopic unit of King Chulalongkorn Memorial Hospital from June 2007 to January 2013. A database search using keywords "upper gastrointestinal bleeding" and "iron deficiency" was used. From 4,454 diagnoses, after exclusion criteria, 3,488 patients (2,042 male (58.5%) and 1,446 female (41.5%); mean age 63.3 ± 15.94 years, range 13-103 years) were included. Results: The three most common causes of UGIB were peptic ulcer (38.2%), nonulcer-mucosal lesions (23.4%), and esophageal-related causes (20.4%). The 5 year-incidence of H. pylori was 25%−30%. The overall prevalence was 27%. The prevalence of H. pylori infection was found to decrease with age from 43.8% at <40 years to 21.7% at >79 years old. H. pylori infection was significantly associated with duodenal and gastroduodenal ulcers. Cirrhosis and nonulcer-mucosal lesions were significantly unrelated to H. pylori infection. Patients with concurrent cirrhosis with peptic ulcer were found to be negative for H. pylori infection. Conclusion: Peptic ulcer is the leading cause of UGIB in Thailand. However, its incidence is declining. Patients who presented to hospital with UGIB were older, compared with those a decade ago. H. pylori infection plays an important role in UGIB and its incidence was stable during the past 5 years.

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“…40 In Japan, the ratio of observed versus expected deaths was actually higher for cirrhosis than for heart disease in people with diabetes (2.67 vs. 1.81). 41 Longitudinal studies of NASH are few in number.…”

Section: Clinical Aspectsmentioning

confidence: 97%