Document Detail


Risk factors of recipient receiving living donor liver transplantation in the comprehensive era of indication and perioperative managements.
MedLine Citation:
PMID:  20942266     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Living donor liver transplantation (LDLT) has become one of the chief methods of saving patients with end-stage liver disease due to liver cirrhosis. Accumulation of knowledge about indication and perioperative managements improve outcome of this treatment. In this study, we elucidate the risk factors of LDLT, which still exist today. Sixty-one patients received LDLT in our institute between 2003 and 2009 were included in this study. Recipient age and sex, donor age and sex, etiology, preoperative model of end-stage liver disease (MELD) score, hepatocellular carcinoma (HCC), graft versus recipient weight ratio (GRWR), cold and warm ischemic time, operation time, blood loss, ABO compatibility, rejection, cytomegalovirus (CMV) infection, biliary stricture, and calcineurin inhibitor (FK506 or cyclosporin A) were the factors investigated. p < 0.05 was considered as statistically significant in the proportional hazard model. In univariate analysis, the recipients' age (p = 0.024) and rejection episode (p = 0.046) were selected as significant risk factors. In multivariate analysis including the factors that showed p < 0.2 (recipient age, GRWR, ABO compatibility, rejection episode) in univariate analysis, recipient age (p = 0.008, HR: 1.40; 95% CI: 1.09-1.80) and rejection episodes (p = 0.002, HR: 13.33; 95% CI: 2.53-71.43) were still selected as significant independent risk factors after LDLT. Recipient age was shown to be 1.40 times risk per 1 year older and the rejection episode was shown to be 13.33 times risk in the recent era with comprehensive indication and preoperative management for LDLT. Indication must be cautious for elderly patients, and prevention of rejection is crucial for the improvement of results for LDLT.
Authors:
Masatoshi Ishigami; Yoshiaki Katano; Kazuhiko Hayashi; Akihiro Ito; Yoshiki Hirooka; Yasuharu Onishi; Taro Nakamura; Tetsuya Kiuchi; Hidemi Goto
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nagoya journal of medical science     Volume:  72     ISSN:  0027-7622     ISO Abbreviation:  Nagoya J Med Sci     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-10-14     Completed Date:  2010-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0412011     Medline TA:  Nagoya J Med Sci     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  119-27     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan. masaishi@med.nagoya-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Humans
Liver Cirrhosis / mortality*,  surgery*
Liver Failure / mortality,  surgery
Liver Transplantation / mortality*,  statistics & numerical data
Living Donors / statistics & numerical data*
Male
Middle Aged
Perioperative Care*
Prognosis
Risk Factors
Survival Analysis
Young Adult

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