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Article: Outcomes of living donor liver transplantation for patients with preoperative type 1 hepatorenal syndrome and acute hepatic decompensation

TitleOutcomes of living donor liver transplantation for patients with preoperative type 1 hepatorenal syndrome and acute hepatic decompensation
Authors
Issue Date2012
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021
Citation
Liver Transplantation, 2012, v. 18 n. 7, p. 779-785 How to Cite?
AbstractThis study investigated the outcomes of living donor liver transplantation (LDLT) for patients with preoperative type 1 hepatorenal syndrome (HRS) and acute hepatic decompensation. Prospectively collected data for 104 patients who had fulminant hepatic failure, acute decompensation of cirrhosis, or an acute flare of chronic hepatitis B were analyzed. Thirty-three patients (31.7%) had HRS (the HRS group), and 71 patients (68.3%) did not (the non-HRS group). The median follow-up period was 60 months. The HRS group had significantly more preoperative intensive care unit (ICU) admissions (84.8% versus 60.6%, P = 0.01), worse preoperative blood test results (creatinine, 248 versus 88 μmol/L, P < 0.001; total bilirubin, 630 versus 555 μmol/L, P = 0.001), more hemodialysis (48.5% versus 0%, P < 0.001), more blood transfusions (9 versus 4 U, P < 0.001), longer postoperative ICU stays (8 versus 4 days, P < 0.001), worse postoperative blood test results (creatinine at 1 year, 108 versus 96 μmol/L, P = 0.006), and poorer overall survival (P < 0.001). In a multivariate analysis, only HRS was associated with poorer overall survival (hazard ratio = 8.592, 95% confidence interval = 1.782-41.431, P = 0.007). In conclusion, HRS patients had worse postoperative renal function and overall survival than non-HRS patients. However, their 5-year overall survival rate was still nearly 80%, which is satisfactory. Therefore, LDLT can be considered for patients who have acute hepatic decompensation with or without HRS. © 2012 American Association for the Study of Liver Diseases.
Persistent Identifierhttp://hdl.handle.net/10722/145902
ISSN
2015 Impact Factor: 3.951
2015 SCImago Journal Rankings: 1.763
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChok, KSHen_HK
dc.contributor.authorFung, JYYen_HK
dc.contributor.authorChan, SCen_HK
dc.contributor.authorCheung, TTen_HK
dc.contributor.authorSharr, WWen_HK
dc.contributor.authorChan, ACYen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLo, CMen_HK
dc.date.accessioned2012-03-27T09:01:24Z-
dc.date.available2012-03-27T09:01:24Z-
dc.date.issued2012en_HK
dc.identifier.citationLiver Transplantation, 2012, v. 18 n. 7, p. 779-785en_HK
dc.identifier.issn1527-6465en_HK
dc.identifier.urihttp://hdl.handle.net/10722/145902-
dc.description.abstractThis study investigated the outcomes of living donor liver transplantation (LDLT) for patients with preoperative type 1 hepatorenal syndrome (HRS) and acute hepatic decompensation. Prospectively collected data for 104 patients who had fulminant hepatic failure, acute decompensation of cirrhosis, or an acute flare of chronic hepatitis B were analyzed. Thirty-three patients (31.7%) had HRS (the HRS group), and 71 patients (68.3%) did not (the non-HRS group). The median follow-up period was 60 months. The HRS group had significantly more preoperative intensive care unit (ICU) admissions (84.8% versus 60.6%, P = 0.01), worse preoperative blood test results (creatinine, 248 versus 88 μmol/L, P < 0.001; total bilirubin, 630 versus 555 μmol/L, P = 0.001), more hemodialysis (48.5% versus 0%, P < 0.001), more blood transfusions (9 versus 4 U, P < 0.001), longer postoperative ICU stays (8 versus 4 days, P < 0.001), worse postoperative blood test results (creatinine at 1 year, 108 versus 96 μmol/L, P = 0.006), and poorer overall survival (P < 0.001). In a multivariate analysis, only HRS was associated with poorer overall survival (hazard ratio = 8.592, 95% confidence interval = 1.782-41.431, P = 0.007). In conclusion, HRS patients had worse postoperative renal function and overall survival than non-HRS patients. However, their 5-year overall survival rate was still nearly 80%, which is satisfactory. Therefore, LDLT can be considered for patients who have acute hepatic decompensation with or without HRS. © 2012 American Association for the Study of Liver Diseases.en_HK
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021en_HK
dc.relation.ispartofLiver Transplantationen_HK
dc.rightsLiver Transplantation. Copyright © John Wiley & Sons, Inc.-
dc.titleOutcomes of living donor liver transplantation for patients with preoperative type 1 hepatorenal syndrome and acute hepatic decompensationen_HK
dc.typeArticleen_HK
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityChan, SC=rp01568en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/lt.23401en_HK
dc.identifier.pmid22290625-
dc.identifier.scopuseid_2-s2.0-84863952777en_HK
dc.identifier.hkuros198962en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84863952777&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume18en_HK
dc.identifier.issue7en_HK
dc.identifier.spage779en_HK
dc.identifier.epage785en_HK
dc.identifier.isiWOS:000306318100006-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChok, KSH=6508229426en_HK
dc.identifier.scopusauthoridFung, JYY=55003370300en_HK
dc.identifier.scopusauthoridChan, SC=7404255575en_HK
dc.identifier.scopusauthoridCheung, TT=7103334165en_HK
dc.identifier.scopusauthoridSharr, WW=36864499000en_HK
dc.identifier.scopusauthoridChan, ACY=55316039800en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLo, CM=55261732500en_HK

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