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Conference Paper: Prediction of hospital mortality after liver transplantation for acute liver failure

TitlePrediction of hospital mortality after liver transplantation for acute liver failure
Authors
KeywordsMedical sciences
Gastroenterology medical sciences
Surgery
Issue Date2010
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021
Citation
The 16th Annual International Congress of the International Liver Transplantation Society (ILTS 2010), Hong Kong, 16-19 June 2010. In Liver Transplantation, 2010, v. 16 suppl. S1, p. S146, abstract no. P-93 How to Cite?
AbstractBACKGROUND: The prognosis of acute liver failure (ALF) is dismal without a timely liver transplantation. Data on predicting hospital mortality after liver transplantation in such high urgency situation is scarce. Our aim was to identify factors associated with hospital mortality after liver transplantation for ALF. MATERIALS AND METHODS: From November 1991 to December 2007, 175 patients underwent liver transplantation for acute liver failure in our center. Among them, 32 patients had fulminant hepatic failure, and 143 patients had acute-on-chronic liver failure. Data including demographics, perioperative factors and postoperative outcomes were reviewed. Hospital mortality was defined as all causes of death within the same hospital admission after transplantation. Comparison was made between patients who survived (Group I) and died (Group II) after transplantation. Predictive factors for mortality were identified by multivariate analysis. P-value < 0.05 was considered to be significant. RESULTS: 130 patients received live donor liver transplantation and 45 patients received deceased donor liver transplantation. Acute flare up of hepatitis B infection was the most common etiology of ALF in our study (80%). The hospital mortality rate was 4.6% (n=8). There was no significant difference in age, co-morbid illness and etiology of ALF between the two groups. The incidence of infected ascites (P=0.046) and hepatorenal syndrome (P=0.003) were significantly higher in Group II. The median MELD score was 35 and 45 in group I and II, respectively (P=0.001). Perioperative blood transfusion requirement (P=0.001) and need for intraoperative haemodialysis (P=0.001) were also higher in Group II. Multivariate analysis identified preoperative serum urea level and perioperative haemodialysis to be factors associated with mortality after liver transplantation for ALF. All deaths occurred within 4.3 months after transplantation. The causes of mortality were fungal infection (n=2), thrombotic thrombocytopenic purpura (n=1), multiorgan failure (n=1), necrotizing pancreatitis (n=1), gut ischemia (n=1), intracranial hemorrhage (n=1) and pneumonia (n=1). The 3- and 5-year overall survival rates were both 95.4%. CONCLUSION: Liver transplantation for ALF could attain satisfactory short and long-term outcomes in these critically ill patients.
DescriptionPoster Session 1 - Outcomes: P-93
Persistent Identifierhttp://hdl.handle.net/10722/127006
ISSN
2015 Impact Factor: 3.951
2015 SCImago Journal Rankings: 1.763

 

DC FieldValueLanguage
dc.contributor.authorChan, ACYen_HK
dc.contributor.authorCheung, TTen_HK
dc.contributor.authorChok, KSHen_HK
dc.contributor.authorSharr, WW-
dc.contributor.authorNg, KKC-
dc.contributor.authorChan, SC-
dc.contributor.authorLo, CM-
dc.contributor.authorFan, ST-
dc.date.accessioned2010-10-31T13:00:57Z-
dc.date.available2010-10-31T13:00:57Z-
dc.date.issued2010en_HK
dc.identifier.citationThe 16th Annual International Congress of the International Liver Transplantation Society (ILTS 2010), Hong Kong, 16-19 June 2010. In Liver Transplantation, 2010, v. 16 suppl. S1, p. S146, abstract no. P-93en_HK
dc.identifier.issn1527-6465-
dc.identifier.urihttp://hdl.handle.net/10722/127006-
dc.descriptionPoster Session 1 - Outcomes: P-93-
dc.description.abstractBACKGROUND: The prognosis of acute liver failure (ALF) is dismal without a timely liver transplantation. Data on predicting hospital mortality after liver transplantation in such high urgency situation is scarce. Our aim was to identify factors associated with hospital mortality after liver transplantation for ALF. MATERIALS AND METHODS: From November 1991 to December 2007, 175 patients underwent liver transplantation for acute liver failure in our center. Among them, 32 patients had fulminant hepatic failure, and 143 patients had acute-on-chronic liver failure. Data including demographics, perioperative factors and postoperative outcomes were reviewed. Hospital mortality was defined as all causes of death within the same hospital admission after transplantation. Comparison was made between patients who survived (Group I) and died (Group II) after transplantation. Predictive factors for mortality were identified by multivariate analysis. P-value < 0.05 was considered to be significant. RESULTS: 130 patients received live donor liver transplantation and 45 patients received deceased donor liver transplantation. Acute flare up of hepatitis B infection was the most common etiology of ALF in our study (80%). The hospital mortality rate was 4.6% (n=8). There was no significant difference in age, co-morbid illness and etiology of ALF between the two groups. The incidence of infected ascites (P=0.046) and hepatorenal syndrome (P=0.003) were significantly higher in Group II. The median MELD score was 35 and 45 in group I and II, respectively (P=0.001). Perioperative blood transfusion requirement (P=0.001) and need for intraoperative haemodialysis (P=0.001) were also higher in Group II. Multivariate analysis identified preoperative serum urea level and perioperative haemodialysis to be factors associated with mortality after liver transplantation for ALF. All deaths occurred within 4.3 months after transplantation. The causes of mortality were fungal infection (n=2), thrombotic thrombocytopenic purpura (n=1), multiorgan failure (n=1), necrotizing pancreatitis (n=1), gut ischemia (n=1), intracranial hemorrhage (n=1) and pneumonia (n=1). The 3- and 5-year overall survival rates were both 95.4%. CONCLUSION: Liver transplantation for ALF could attain satisfactory short and long-term outcomes in these critically ill patients.-
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021-
dc.relation.ispartofLiver Transplantation-
dc.rightsLiver Transplantation. Copyright © John Wiley & Sons, Inc.-
dc.subjectMedical sciences-
dc.subjectGastroenterology medical sciences-
dc.subjectSurgery-
dc.titlePrediction of hospital mortality after liver transplantation for acute liver failureen_HK
dc.typeConference_Paperen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1527-6465&volume=16&issue=Suppl. S1&spage=S146, abstract no. P&epage=93&date=2010&atitle=Prediction+of+hospital+mortality+after+liver+transplantation+for+acute+liver+failure-
dc.identifier.emailChan, ACY: albertchan@medscape.comen_HK
dc.identifier.emailCheung, TT: cheung68@hku.hken_HK
dc.identifier.emailChok, KSH: kennethchok@yahoo.com.hken_HK
dc.identifier.emailNg, KKC: kkcng@HKUCC.hku.hk-
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hk-
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hk-
dc.identifier.emailFan, ST: stfan@hku.hk-
dc.identifier.authorityChan, ACY=rp00310en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.natureLink_to_subscribed_fulltext-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1002/lt.22086-
dc.identifier.hkuros172630en_HK
dc.identifier.volume16-
dc.identifier.issuesuppl. S1-
dc.identifier.spageS146, abstract no. P-93-
dc.identifier.epageS146, abstract no. P-93-
dc.description.otherThe 16th Annual International Congress of the International Liver Transplantation Society (ILTS), Hong Kong, 16-19 June 2010. In Liver Transplantation, 2010, v. 16, Suppl. S1, p. S146, abstract no. P-93-

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