Predictors of early recipient mortality after living donor liver transplantation in a tertiary care center in Egypt.

Autor:	Nafea MA; From the Department of General Surgery, Al-Azhar University, Cairo, Egypt., Alsebaey A; From the Department of Gastroenterology and Hepatology, National Liver Institute, Shebin El-Kom, Egypt., Abd El Aal Sultan A; From the Department of General Surgery, Al-Azhar University, Cairo, Egypt., Goda MH; From the Department of General Surgery, Ain Shams University, Cairo, Egypt., Salman A; From the Department of Internal Medicine, Faculty of Medicine University Kasr, Cairo, Egypt., Rashed HS; From the Department of Anesthesia, National Liver Institute, Shebin El-Kom, Egypt., Soliman A; From the Department of Internal Medicine, Faculty of Medicine University Kasr, Cairo, Egypt., Elshenoufy M; From the Department of Internal Medicine, Faculty of Medicine University Kasr, Cairo, Egypt., Abdelrahman M; From the Department of General Surgery, Ain Shams University, Cairo, Egypt.
Jazyk:	angličtina
Zdroj:	Annals of Saudi medicine [Ann Saudi Med] 2019 Sep-Oct; Vol. 39 (5), pp. 337-344. Date of Electronic Publication: 2019 Oct 03.
DOI:	10.5144/0256-4947.2019.337
Abstrakt:	Background: Living donor liver transplantation (LDLT) has evolved into a widely accepted therapeutic option. Many different risk factors may affect early mortality after LDLT. Objectives: Analyze risk factors that can affect early (<6 months) mortality of patients after LDLT in a single center. Design: Retrospective chart review of patients who underwent LDLT. Setting: University hospital. Patients and Methods: Adult cirrhotic patients who underwent LDLT were classified by early (first 6 months) or late mortality. A full pre, intra- and post-operative evaluation had been done on all patients including a full history, examination and investigations to identify risk factors that might affect mortality post-LDLT. Main Outcome Measures: Determination of pre-, intra- or postoperative factors that might affect recipient mortality post-LDLT. Sample Size: 123. Results: Pre-operative factors that increased early mortality in a univariate analysis were higher model for end-stage liver disease (MELD) scores, lower graft-recipient weigh ratio (GRWR), older donor age, and recurrent spontaneous bacterial peritonitis. Intraoperative factors included more transfusion units of blood, plasma, platelets and cryoprecipitate, a longer time for cold and warm ischemia, and a longer anhepatic phase among others. Postoperative factors included a longer ICU or hospital stay and abnormal postoperative laboratory data. In the final logistic regression model, the most significant factors were pre-operative GRWR, length of hospital stay, units of intraoperative blood transfusion, postoperative alanine aminotransferase, postoperative total leukocyte count, and MELD score. Conclusion: LDLT outcomes might be improved by attempting to resolve clinical factors that have been identified as contributors to early post-LDLT mortality. Limitations: More risk factors, such as those relevant to patient portal vein hemodynamics, should be included in an analysis of predictors of early mortality. Conflict of Interest: None.
Databáze:	MEDLINE
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