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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

TitleSurvival outcomes of right-lobe living donor liver transplantation for patients with high model for end-stage liver disease scores
Authors
KeywordsSurvival
Living donor liver transplantation
Model for end-stage liver disease
Right-lobe
Issue Date2013
Citation
Hepatobiliary and Pancreatic Diseases International, 2013, v. 12, n. 3, p. 256-262 How to Cite?
AbstractBACKGROUND: 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 Identifierhttp://hdl.handle.net/10722/221342
ISSN
2015 Impact Factor: 1.724
2015 SCImago Journal Rankings: 0.717
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChok, KSH-
dc.contributor.authorChan, SC-
dc.contributor.authorFung, JYY-
dc.contributor.authorCheung, TT-
dc.contributor.authorChan, ACY-
dc.contributor.authorFan, ST-
dc.contributor.authorLo, CM-
dc.date.accessioned2015-11-18T06:09:03Z-
dc.date.available2015-11-18T06:09:03Z-
dc.date.issued2013-
dc.identifier.citationHepatobiliary and Pancreatic Diseases International, 2013, v. 12, n. 3, p. 256-262-
dc.identifier.issn1499-3872-
dc.identifier.urihttp://hdl.handle.net/10722/221342-
dc.description.abstractBACKGROUND: 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.languageeng-
dc.relation.ispartofHepatobiliary and Pancreatic Diseases International-
dc.subjectSurvival-
dc.subjectLiving donor liver transplantation-
dc.subjectModel for end-stage liver disease-
dc.subjectRight-lobe-
dc.titleSurvival outcomes of right-lobe living donor liver transplantation for patients with high model for end-stage liver disease scores-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S1499-3872(13)60042-9-
dc.identifier.pmid23742770-
dc.identifier.scopuseid_2-s2.0-84879294123-
dc.identifier.hkuros220047-
dc.identifier.volume12-
dc.identifier.issue3-
dc.identifier.spage256-
dc.identifier.epage262-
dc.identifier.isiWOS:000320092700004-

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