4.6 Article

Who Fares Worse After Liver Transplantation? Impact of Donor and Recipient Variables on Outcome: Data from a Prospective Study

Journal

TRANSPLANTATION
Volume 95, Issue 12, Pages 1528-1534

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/TP.0b013e318292827f

Keywords

Liver transplantation; Donor criteria; Recipient features

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Background. Numerous donor and recipient risk factors influence survival after liver transplantation (LT). Methods. The aim of this study was to prospectively evaluate the effect of donor and recipient variables on 12-month patient and graft survival after LT. Five hundred forty-six patients underwent LT in a single center (2000-2010). Results. Bilirubin (P=0.006) and cold ischemia time (P=0.002) were predictive of graft loss at 12 months after LT. Model for End-Stage Liver Disease score >= 25 was associated with a lower 12-month graft survival than Model for End-Stage Liver Disease score <15 (P=0.02). Hepatitis C virus (HCV)-positive patients showed a lower survival than HCV-negative patients 12 months after LT (P=0.04), with serum sodium concentration (P=0.01) predictive for graft survival. Donor age demonstrated a trend of prediction (P=0.05) for HCV-positive patient survival. In hepatocellular carcinoma patients, donor age (P=0.02 and 0.02) and use of partial graft (P=0.01 and 0.02) were predictive of patient and graft survival at 12 months after LT. Conclusions. Bilirubin and cold ischemia time are crucial for graft outcome post-LT. Survival in HCV-positive patients is lower than in HCV-negative recipients. Donor age and partial graft use are predictive of patient and graft survival in hepatocellular carcinoma patients.

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