P.159 INFLUENCE OF DONOR—RECIPIENT VARIABLES ON SHORT TERM PATIENT SURVIVAL FOLLOWING LIVER TRANSPLANTATION (LT)

Background. MELD or MELD sodium promotes sicker patients for earlier liver transplantation (LT); the balance between pre- and post-LT outcomes is still controversial. Aim. To compare MELD and related scores’ risk assessment of short-term morbidity and mortality after LT. Methods. We included only transplanted cirrhotic patients from 6/2005 to 6/2010 (). Immediate pre-LT MELD, integrated MELD (iMELD), and two MELD sodium formulas “MELD Na1” and “MELDNa2” were calculated. Results. Pre-LT scores for nonsurvivors were higher than those for survivors: MELD (28 ± 8 versus 22 ± 7, ), MELD Na1 (33 ± 8 versus 27 ± 10, ), and iMELD (51 ± 6 versus 46 ± 8, ). Patient survival assessment was performed by AUROC analysis (95% CI): MELD 0.694 (0.56–0.82; ), MELD Na1 0.682 (0.56–0.79; ), MELD Na2 0.651 (0.54–0.76; ), and iMELD 0.698 (0.593–0.80; ). Patients with MELD ≥25 points had longer intensive care stay (mean 10 versus 7 days, ) and longer mechanical ventilatory support (5.4 versus 1.9 days, ). Conclusions. The addition of serum sodium to MELD does not improve assessment of mortality after LT. Patients with higher MELD may preclude higher morbidity after transplantation.

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Faculty Opinions recommendation of The short-term effect of liver transplantation on the low-frequency fluctuation of brain activity in cirrhotic patients with and without overt hepatic encephalopathy.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.729074378.793535969 ◽

2017 ◽

Author(s):

Sharon DeMorrow

Keyword(s):

Liver Transplantation ◽

Hepatic Encephalopathy ◽

Brain Activity ◽

Low Frequency ◽

Term Effect ◽

Frequency Fluctuation ◽

Short Term ◽

Short Term Effect ◽

Overt Hepatic Encephalopathy ◽

Cirrhotic Patients

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Short-term and long-term outcomes in living donors for liver transplantation: Cohort study

International Journal of Surgery ◽

10.1016/j.ijsu.2020.11.013 ◽

2020 ◽

Vol 84 ◽

pp. 147-153

Author(s):

Kosei Takagi ◽

Yuzo Umeda ◽

Ryuichi Yoshida ◽

Nobuyuki Watanabe ◽

Takashi Kuise ◽

...

Keyword(s):

Liver Transplantation ◽

Cohort Study ◽

Living Donors ◽

Long Term Outcomes ◽

Short Term

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Incidence, Characteristics, and Prognosis of Incidentally Discovered Hepatocellular Carcinoma after Liver Transplantation

Journal of Transplantation ◽

10.1155/2016/1916387 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Walid El Moghazy ◽

Samy Kashkoush ◽

Glenda Meeberg ◽

Norman Kneteman

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Tumor Recurrence ◽

Patient Survival ◽

Steady Increase ◽

Liver Transplants ◽

Significant Difference ◽

One Year ◽

Over Time

Background. We aimed to assess incidentally discovered hepatocellular carcinoma (iHCC) over time and to compare outcome to preoperatively diagnosed hepatocellular carcinoma (pdHCC) and nontumor liver transplants.Methods.We studied adults transplanted with a follow-up of at least one year. Patients were divided into 3 groups according to diagnosis of hepatocellular carcinoma.Results.Between 1990 and 2010, 887 adults were transplanted. Among them, 121 patients (13.6%) had pdHCC and 32 patients (3.6%) had iHCC; frequency of iHCC decreased markedly over years, in parallel with significant increase in pdHCC. Between 1990 and 1995, 120 patients had liver transplants, 4 (3.3%) of them had iHCC, and only 3 (2.5%) had pdHCC, while in the last 5 years, 263 patients were transplanted, 7 (0.03%) of them had iHCC, and 66 (25.1%) had pdHCC (P<0.001). There was no significant difference between groups regarding patient survival; 5-year survival was 74%, 75.5%, and 77.3% in iHCC, pdHCC, and non-HCC groups, respectively (P=0.702). Patients with iHCC had no recurrences after transplant, while pdHCC patients experienced 17 recurrences (15.3%) (P=0.016).Conclusions.iHCC has significantly decreased despite steady increase in number of transplants for hepatocellular carcinoma. Patients with iHCC had excellent outcomes with no tumor recurrence and survival comparable to pdHCC.

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Perioperative loss of psoas muscle is associated with patient survival in living donor liver transplantation

Liver Transplantation ◽

10.1002/lt.25063 ◽

2018 ◽

Vol 24 (6) ◽

pp. 845-846 ◽

Cited By ~ 2

Author(s):

Fu-Shan Xue ◽

Ya-Yang Liu ◽

Qing Liu

Keyword(s):

Liver Transplantation ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Patient Survival ◽

Psoas Muscle ◽

Donor Liver ◽

Donor Liver Transplantation

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Bioimpedance Guided Fluid Management in Peritoneal Dialysis

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.06480619 ◽

2020 ◽

Vol 15 (5) ◽

pp. 685-694 ◽

Cited By ~ 2

Author(s):

Na Tian ◽

Xiao Yang ◽

Qunying Guo ◽

Qian Zhou ◽

Chunyan Yi ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Patient Survival ◽

Fluid Management ◽

Volume Overload ◽

Short Term ◽

Cardiovascular Disease Mortality ◽

Technique Survival ◽

Disease Mortality ◽

Clinical Methods ◽

And Control

Background and objectivesBioelectrical impedance analysis (BIA) devices can help assess volume overload in patients receiving maintenance peritoneal dialysis. However, the effects of BIA on the short-term hard end points of peritoneal dialysis lack consistency. This study aimed to test whether BIA-guided fluid management could improve short-term outcomes in patients on peritoneal dialysis.Design, setting, participants, & measurementsA single-center, open-labeled, randomized, controlled trial was conducted. Patients on prevalent peritoneal dialysis with volume overload were recruited from July 1, 2013 to March 30, 2014 and followed for 1 year in the initial protocol. All participants with volume overload were 1:1 randomized to the BIA-guided arm (BIA and traditional clinical methods) and control arm (only traditional clinical methods). The primary end point was all-cause mortality and secondary end points were cardiovascular disease mortality and technique survival.ResultsA total of 240 patients (mean age, 49 years; men, 51%; diabetic, 21%, 120 per group) were enrolled. After 1-year follow-up, 11(5%) patients died (three in BIA versus eight in control) and 21 patients were permanently transferred to hemodialysis (eight in BIA versus 13 in control). The rate of extracellular water/total body water decline in the BIA group was significantly higher than that in the control group. The 1-year patient survival rates were 96% and 92% in BIA and control groups, respectively. No significant statistical differences were found between patients randomized to the BIA-guided or control arm in terms of patient survival, cardiovascular disease mortality, and technique survival (P>0.05).ConclusionsAlthough BIA-guided fluid management improved the fluid overload status better than the traditional clinical method, no significant effect was found on 1-year patient survival and technique survival in patients on peritoneal dialysis.

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