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- Publisher Website: 10.1016/S1499-3872(13)60042-9
- Scopus: eid_2-s2.0-84879294123
- PMID: 23742770
- WOS: WOS:000320092700004
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Article: Survival outcomes of right-lobe living donor liver transplantation for patients with high model for end-stage liver disease scores
Title | Survival outcomes of right-lobe living donor liver transplantation for patients with high model for end-stage liver disease scores |
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Authors | |
Keywords | Survival Living donor liver transplantation Model for end-stage liver disease Right-lobe |
Issue Date | 2013 |
Citation | Hepatobiliary and Pancreatic Diseases International, 2013, v. 12, n. 3, p. 256-262 How to Cite? |
Abstract | BACKGROUND: Controversy exists over whether living donor liver transplantation (LDLT) should be offered to patients with high Model for End-stage Liver Disease (MELD) scores. This study tried to determine whether a high MELD score would result in inferior outcomes of right-lobe LDLT. METHODS: Among 411 consecutive patients who received right-lobe LDLT at our center, 143 were included in this study. The patients were divided into two groups according to their MELD scores: a high-score group (MELD score >25; n=75) and allow-score group (MELD score <25; n=68). Their demographic data and perioperative conditions were compared. Univariable and multivariable analyses were performed to identify risk factors affecting patient survival. RESULTS: In the high-score group, more patients required preoperative intensive care unit admission (49.3% vs 2.9%; P<0.001), mechanical ventilation (21.3% vs 0%; P<0.001), or hemodialysis (13.3% vs 0%; P=0.005); the waiting time before LDLT was shorter (4 vs 66 days; P<0.001); more blood was transfused during operation (7 vs 2 units; P<0.001); patients stayed longer in the intensive care unit (6 vs 3 days; P<0.001) and hospital (21 vs 15 days; P=0.015) after transplantation; more patients developed early postoperative complications (69.3% vs 50.0%; P=0.018); and values of postoperative peak blood parameters were higher. However, the two groups had comparable hospital mortality. Graft survival and patient overall survival at one year (94.7% vs 95.6%; 95.9% vs 96.9%), three years (91.9% vs 92.6%; 93.2% vs 95.3%), and five years (90.2% vs 90.2%; 93.2% vs 95.3%) were also similar between the groups. CONCLUSIONS: Although the high-score group had significantly more early postoperative complications, the two groups had comparable hospital mortality and similar satisfactory rates of graft survival and patient overall survival. Therefore, a high MELD score should not be a contraindication to right-lobe LDLT if donor risk and recipient benefit are taken into full account. © 2013, Hepatobiliary Pancreat Dis Int. All rights reserved. |
Persistent Identifier | http://hdl.handle.net/10722/221342 |
ISSN | 2023 Impact Factor: 3.6 2023 SCImago Journal Rankings: 0.720 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Chok, KSH | - |
dc.contributor.author | Chan, SC | - |
dc.contributor.author | Fung, JYY | - |
dc.contributor.author | Cheung, TT | - |
dc.contributor.author | Chan, ACY | - |
dc.contributor.author | Fan, ST | - |
dc.contributor.author | Lo, CM | - |
dc.date.accessioned | 2015-11-18T06:09:03Z | - |
dc.date.available | 2015-11-18T06:09:03Z | - |
dc.date.issued | 2013 | - |
dc.identifier.citation | Hepatobiliary and Pancreatic Diseases International, 2013, v. 12, n. 3, p. 256-262 | - |
dc.identifier.issn | 1499-3872 | - |
dc.identifier.uri | http://hdl.handle.net/10722/221342 | - |
dc.description.abstract | BACKGROUND: Controversy exists over whether living donor liver transplantation (LDLT) should be offered to patients with high Model for End-stage Liver Disease (MELD) scores. This study tried to determine whether a high MELD score would result in inferior outcomes of right-lobe LDLT. METHODS: Among 411 consecutive patients who received right-lobe LDLT at our center, 143 were included in this study. The patients were divided into two groups according to their MELD scores: a high-score group (MELD score >25; n=75) and allow-score group (MELD score <25; n=68). Their demographic data and perioperative conditions were compared. Univariable and multivariable analyses were performed to identify risk factors affecting patient survival. RESULTS: In the high-score group, more patients required preoperative intensive care unit admission (49.3% vs 2.9%; P<0.001), mechanical ventilation (21.3% vs 0%; P<0.001), or hemodialysis (13.3% vs 0%; P=0.005); the waiting time before LDLT was shorter (4 vs 66 days; P<0.001); more blood was transfused during operation (7 vs 2 units; P<0.001); patients stayed longer in the intensive care unit (6 vs 3 days; P<0.001) and hospital (21 vs 15 days; P=0.015) after transplantation; more patients developed early postoperative complications (69.3% vs 50.0%; P=0.018); and values of postoperative peak blood parameters were higher. However, the two groups had comparable hospital mortality. Graft survival and patient overall survival at one year (94.7% vs 95.6%; 95.9% vs 96.9%), three years (91.9% vs 92.6%; 93.2% vs 95.3%), and five years (90.2% vs 90.2%; 93.2% vs 95.3%) were also similar between the groups. CONCLUSIONS: Although the high-score group had significantly more early postoperative complications, the two groups had comparable hospital mortality and similar satisfactory rates of graft survival and patient overall survival. Therefore, a high MELD score should not be a contraindication to right-lobe LDLT if donor risk and recipient benefit are taken into full account. © 2013, Hepatobiliary Pancreat Dis Int. All rights reserved. | - |
dc.language | eng | - |
dc.relation.ispartof | Hepatobiliary and Pancreatic Diseases International | - |
dc.subject | Survival | - |
dc.subject | Living donor liver transplantation | - |
dc.subject | Model for end-stage liver disease | - |
dc.subject | Right-lobe | - |
dc.title | Survival outcomes of right-lobe living donor liver transplantation for patients with high model for end-stage liver disease scores | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/S1499-3872(13)60042-9 | - |
dc.identifier.pmid | 23742770 | - |
dc.identifier.scopus | eid_2-s2.0-84879294123 | - |
dc.identifier.hkuros | 220047 | - |
dc.identifier.volume | 12 | - |
dc.identifier.issue | 3 | - |
dc.identifier.spage | 256 | - |
dc.identifier.epage | 262 | - |
dc.identifier.isi | WOS:000320092700004 | - |
dc.identifier.issnl | 2352-9377 | - |