Predictive Factors of Early Mortality after Living Donor Liver Transplantation: A Single Center Experience of 780 Cases over 16 Years

Q4 Medicine

Surgery, Gastroenterology and Oncology Pub Date : 2021-01-01 DOI:10.21614/SGO-26-329

M. Wahab, A. Sultan, Amr Yasesn, O. Fathi, T. Salah, Mohamed M. Elshobari, M. Elsadany, E. E. Abdel-Khalek, M. Elmorshedi, A. Monir, Mohamed Eldesoky, R. Said, M. M. Emara, M. Abdelkhalek, M. Elsedeiq, Karem Abuzeed, A. Shehta

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引用次数: 0

Abstract

Introduction: Living-donor liver transplantation (LDLT) is a complex procedure requiring a special perioperative patients’ care. Despite the improvements in the operative techniques and perioperative care, early postoperative mortality remains a disappointing event. The current study is conducted to determine the incidence, causes and potential predictive factors of early postoperative mortality after LDLT. Methods: We reviewed the data of patients who underwent LDLT during the period between May 2004 till October 2020. Results: During the study period, 780 cases underwent LDLT. Early Mortality occurred in 109 cases (14%). We divided our cases into two groups, Early Mortality group (n=109) and Survivors group (n=671). Higher preoperative INR, creatinine, and MELD score were found in Early Mortality group. More blood loss and perioperative transfusions were found in Early Mortality group. Longer ICU stay with higher incidence of pulmonary and vascular complications were found in Early Mortality group. Preoperative MELD score, blood transfusion, pulmonary complications, and vascular complications were significant predictors of early mortality in multivariate analysis. Conclusion: Reduction of perioperative transfusions together with early detection and management of vascular and respiratory complications are essential to reduce early mortality after LDLT.

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活体肝移植术后早期死亡的预测因素:16年来780例单中心经验

活体肝移植(LDLT)是一项复杂的手术，需要特殊的围手术期患者护理。尽管手术技术和围手术期护理有所改善，但术后早期死亡率仍然令人失望。本研究旨在确定LDLT术后早期死亡率的发生率、原因及潜在预测因素。方法:我们回顾了2004年5月至2020年10月期间接受LDLT治疗的患者的数据。结果:在研究期间，780例患者接受了LDLT治疗。早期死亡109例(14%)。我们将病例分为两组，早期死亡组(n=109)和幸存者组(n=671)。早亡组术前INR、肌酐、MELD评分较高。早亡组出血量和围手术期输血较多。早亡组住院时间较长，肺部及血管并发症发生率较高。在多变量分析中，术前MELD评分、输血、肺部并发症和血管并发症是早期死亡率的重要预测因子。结论:减少围手术期输血，早期发现和处理血管和呼吸并发症是降低LDLT术后早期死亡率的关键。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery, Gastroenterology and Oncology Medicine-Gastroenterology

CiteScore

0.30

自引率

0.00%

发文量

期刊介绍： Starting with this issue "Annals of Fundeni Hospital", founded in 1996 as the scientific journal of the prestigious hospital Fundeni becomes "Journal of Translational Medicine and Research" (JTMR), an Journal of the Academy of Medical Sciences of Romania. Therefore, an 18 years old Journal, attested and indexed in Elsevier Bibliographic Databases, Amsterdam and also indexed in SCOPUS, is continuing a tradition of excellence that lasted almost two decades. The new title of the Journal is inspired first of all from the important developments of translational research In Fundeni Clinical Institute and the "C.C Iliescu Institute for Cardio-Vascular Diseases", in parallel with the national and international trend to promote and develop this important area or medical research. Although devoted mainly to translational research, JTMR will continue to promote both basic and clinical research.