Comorbidities have a limited impact on post-transplant survival in carefully selected cirrhotic patients: a population-based cohort study
Título del documento: Comorbidities have a limited impact on post-transplant survival in carefully selected cirrhotic patients: a population-based cohort study
Revista: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000411752
ISSN: 1665-2681
Autores: 1
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Instituciones: 1University of Alberta, Faculty of Medicine and Dentistry, Edmonton, Alberta. Canadá
2Alberta Health Services, Liver Transplant Program, Edmonton, Alberta. Canadá
Año:
Periodo: Jul-Ago
Volumen: 14
Número: 4
Paginación: 505-514
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés Improving estimation of long-term survival of patients with end-stage liver disease after orthotopic liver transplantation (OLT) would optimize decisions on eligibility for transplant. We aimed to externally validate previously derived Charlson Comorbity Index for OLT (CCI-OLT); subsequently, we developed a new model to predict 5-year mortality after transplant. Material and methods. This single center retrospective cohort study included 524 consecutive adult cirrhotic patients who underwent OLT in 2002-2012. External validation of CCI-OLT used Kaplan-Meier method. Derivation of the new predictive model used Cox proportional hazards regression. Results. One-, 3-, and 5-year cumulative survival after OLT was 89%, 80%, and 73%, respectively. CCI-OLT was not associated with 5-year mortality after transplant (P = 0.34). We derived and internally validated a new predictive model of 5-year mortality after OLT based on six pre-transplant characteristics of patients: age, body mass index, hepatitis C, hepatic encephalopathy, intensive care unit stay at transplant, and live donor (C-index = 0.64). We further developed a nomogram to estimate individual probability of 1-, 3-, and 5-year survival after OLT. Conclusions. In our cohort, CCI-OLT was not associated with survival following transplant. The new predictive model discriminative capacity was only modest, suggesting that pre-transplant characteristics are of limited value in predicting post-transplant outcomes in thoroughly selected patients
Disciplinas: Medicina
Palabras clave: Cirugía,
Gastroenterología,
Cirrosis,
Trasplante de hígado,
Nomograma,
Sobrevida,
Comorbilidad
Keyword: Medicine,
Gastroenterology,
Surgery,
Cirrhosis,
Liver transplantation,
Nomogram,
Survival,
Comorbidity
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