Risk factors for in-hospital mortality of patients with high model for end-stage liver disease scores following living donor liver transplantation
Título del documento: Risk factors for in-hospital mortality of patients with high model for end-stage liver disease scores following living donor liver transplantation
Revista: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000419205
ISSN: 1665-2681
Autores: 1
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Instituciones: 1Sichuan University, West China Hospital, Sichuan. Puerto Rico
Año:
Periodo: Jul-Ago
Volumen: 11
Número: 4
Paginación: 471-477
País: México
Idioma: Inglés
Tipo de documento: Estadística o encuesta
Enfoque: Analítico
Resumen en inglés Living donor liver transplantation (LDLT) for patients with high model for end-stage liver disease (MELD) scores is controversial due to its poor outcome. However, there is little information regarding which factor would negatively impact the outcome of patients with high MELD scores. The aim of this study was to identify factors associated with the in-hospital mortality of patients with high MELD scores after LDLT. Material and methods. All patients with an MELD scores ≥ 20 who received LDLT from 2005 to 2011 were recruited for the present study. Pre- and intra-operative variables were retrospectively and statistically analyzed. Results. A total of 61 patients were included in the current study. The overall 3-month survival rate was 82% for patients with high MELD scores. Preoperative renal dysfunction, hyponatremia, starting albumin level < 2.8 g/dL, preoperative renal replacement for severe renal failure, anhepatic period > 100 minutes and intraoperative red blood cell (RBC) transfusion ≥ 10 units were identified as potential risk factors by univariate analysis. However, only hyponatremia, preoperative dialysis and massive RBC transfusion were independent risk factors in a multivariate analysis. The 3-month survival rates of patients with two or more independent risk factors and patients with none or one risk factor were 91 and 25%, respectively. A significant difference was observed (P < 0.001). Conclusion. Hyponatremia, preoperative dialysis and massive RBC transfusion were related to poor outcome for sicker patients. Patients with two or more of the above-mentioned risk factors and high MELD scores may exhibit extremely poor short-term survival
Disciplinas: Medicina
Palabras clave: Gastroenterología,
Cirugía,
Diagnóstico,
Trasplantes,
Hígado,
Mortalidad,
Factores de riesgo,
Donadores vivos
Keyword: Gastroenterology,
Surgery,
Diagnosis,
Transplantation,
Liver,
Mortality,
Risk factors,
Living donors
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