Is Elective Status a Predictor of Poor Survival in Liver Retransplantation?
| Autor: | Marek Krawczyk, Oskar Kornasiewicz, Zbigniew Lewandowski, Michał Grąt, Zuzanna Gorski, Rafał Stankiewicz |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Time Factors Liver disease Liver Function Tests Internal medicine medicine RELT Humans Emergency Treatment Survival rate Proportional Hazards Models Retrospective Studies Transplantation Surgical team business.industry Hazard ratio Retrospective cohort study Middle Aged medicine.disease Liver Transplantation Surgery Survival Rate Elective Surgical Procedures Multivariate Analysis Cohort Female business Liver Failure |
| Zdroj: | Transplantation Proceedings. 49:1364-1368 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2017.01.083 |
| Popis: | Background Orthotopic liver retransplantation (reLT) is considered to have poorer outcomes than primary transplantation. The objective of this study was to analyze the impact of medical urgency status as a predictor of patient survival after reLT. Methods Forty-nine patients who underwent reLT were included in this retrospective study. Urgent or elective status was based on the judgment of the surgical team, selected variables, and the Model for End-Stage Liver Disease score. Multivariate analysis was performed to identify variables associated with patient survival following reLT. Results Overall survival of the patient cohort was 57% at 1 year and 54.3% at 3 years after reTL. Survival in urgent-status patients was 68.8% and 63.4% at 1 and 3 years, respectively, whereas the survival rate for elective patients was 40.0% at both time points. Mortality was significantly associated with elective status (hazard ratio [HR], 2.42; P = .046) at 1 year, but was no longer significant (HR, 2.19; P Conclusions Elective status is associated with poorer outcome. Patient selection determines long-term survival more than any other single factor, so for patients designated to an elective status, prompt retransplantation should be encouraged. |
| Databáze: | OpenAIRE |
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