Predicting short-term survival after liver transplantation on eight score systems: a national report from China Liver Transplant Registry

Background. High levels of IGF-1 have been reported in patients with initial poor function of the graft after liver transplantation (LT). Correlation with other clinical variables or early survival has not been extensively investigated.Aim. To evaluate the GH/IGF-1 profile as a function of liver recovery and patients’ early survival after LT.Methods. 30 transplanted patients (23 survivors and 7 nonsurvivors), were retrospectively enrolled in the study. GH and IGF-1 serum levels were assessed at baseline, graft reperfusion, and 1, 7, 15, 30 , 90, and 360 days after LT. Individual biochemical variables were also recorded.Results. After grafting, IGF-1 in blood linearly correlated with cholesterol(r=0.6, P=0.001). IGF-1 levels from day 15 after surgery were statistically higher in survivors as compared to nonsurvivors. ROC curves analysis identified an IGF-1 cut-off >90 μg/L, from day 15 after surgery, as a good predictor of survival (sensitivity 86%, specificity 95%, andP<0.001).Conclusions. After LT, GH levels correlate with the extent of cytolysis, while IGF-1 is an indicator of liver synthetic function recovery. IGF-1 levels >90 μg/L (day 15–30) seem to be an indicator of short-term survival.

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Lack of relationship between preoperative measures of the severity of cirrhosis and short-term survival after liver transplantation

Liver Transplantation and Surgery ◽

10.1002/lt.500030509 ◽

1997 ◽

Vol 3 (5) ◽

pp. 532-537 ◽

Cited By ~ 26

Author(s):

M Deschenes ◽

J P Villeneuve ◽

M Dagenais ◽

D Fenyves ◽

R Lapointe ◽

...

Keyword(s):

Liver Transplantation ◽

Short Term ◽

Term Survival ◽

Short Term Survival

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Absence of relationship between the severity of cirrhosis and short-term survival following liver transplantation Liver Unit, H�pital Saint-Luc, Universit� de Montr�al, Montr�al, Canada

Hepatology ◽

10.1016/0270-9139(95)94289-0 ◽

1995 ◽

Vol 22 (4) ◽

pp. A141

Keyword(s):

Liver Transplantation ◽

Short Term ◽

Term Survival ◽

Liver Unit ◽

Short Term Survival

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Non-selective beta blocker use is associated with improved short-term survival in patients with cirrhosis referred for liver transplantation

BMC Gastroenterology ◽

10.1186/s12876-019-1155-1 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Taiwo Ngwa ◽

Eric Orman ◽

Eduardo Vilar Gomez ◽

Raj Vuppalanchi ◽

Chandrashekhar Kubal ◽

...

Keyword(s):

Liver Transplantation ◽

Beta Blockers ◽

Kidney Injury ◽

Refractory Ascites ◽

Short Term ◽

Term Survival ◽

Bacterial Peritonitis ◽

Stage 1 ◽

Short Term Survival

Abstract Background Recent evidence cautions against the use of non-selective beta-blockers (NSBB) in patients with refractory ascites or spontaneous bacterial peritonitis while other data suggests a survival benefit in patients with advanced liver disease. The aim of this study was to describe the use and impact of NSBB in patients with cirrhosis referred for liver transplantation. Methods A single-center cohort of patients with cirrhosis, who were referred and evaluated for liver transplantation between January and June 2012 were studied for baseline characteristics and clinical outcomes. Patients were grouped according to the use of NSBB at initial evaluation, with the endpoint of 90-day mortality. Results Sixty-five (38%) of 170 consecutive patients evaluated for liver transplantation were taking NSBB. Patients taking NSBB had higher MELD and Child Pugh score. NSBB use was associated with lower 90-day mortality (6% vs. 15%) with a risk adjusted hazard ratio of 0.27 (95%CI .09–0.88, p = .03). Patients taking NSBB developed acute kidney injury (AKI) within 90 days more frequently than patients not taking NSBB (22% vs 11%), p = 0.048). However, this was related to increased stage 1 AKI episodes, all of which resolved. Twelve (27%) of 45 patients with > 90 day follow up discontinued NSBB, most commonly for hypotension and AKI, had increased subsequent MELD and mortality. Conclusions NSBB use in patients with cirrhosis undergoing liver transplant evaluation is associated with better short-term survival. Nevertheless, ongoing tolerance of NSBB in this population is dynamic and may select a subset of patients with better hemodynamic reserve.

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Sa1649 Non-Selective Beta Blocker Use is Associated With Improved Short-term Survival in Patients Referred for Liver Transplantation

Gastroenterology ◽

10.1016/s0016-5085(16)33663-0 ◽

2016 ◽

Vol 150 (4) ◽

pp. S1085-S1086

Author(s):

Taiwo N. Ngwa ◽

Eric Orman ◽

Raj Vuppalanchi ◽

Paul Y. Kwo ◽

Naga P. Chalasani ◽

...

Keyword(s):

Liver Transplantation ◽

Beta Blocker ◽

Short Term ◽

Term Survival ◽

Short Term Survival

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Factors determining short-term survival after adult liver transplantation

Journal of Hepatology ◽

10.1016/s0168-8278(02)80658-4 ◽

2002 ◽

Vol 36 ◽

pp. 186

Author(s):

Rahul Deshpande ◽

Mohamed Rela ◽

Julia Wendon

Keyword(s):

Liver Transplantation ◽

Adult Liver ◽

Short Term ◽

Term Survival ◽

Short Term Survival

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The Danish comorbidity in liver transplant recipients study (DACOLT): a non-interventional prospective observational cohort study

BMC Gastroenterology ◽

10.1186/s12876-021-01733-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Magda Teresa Thomsen ◽

Julie Høgh ◽

Andreas Dehlbæk Knudsen ◽

Anne Marie Reimer Jensen ◽

Marco Gelpi ◽

...

Keyword(s):

Risk Factors ◽

Liver Transplant ◽

Transplant Recipients ◽

Short Term ◽

Term Survival ◽

Blood Samples ◽

Liver Transplant Recipients ◽

Short Term Survival

Abstract Background Liver transplantation is the only curative treatment for patients with end-stage liver disease. Short-term survival has improved due to improved surgical techniques and greater efficacy of immunosuppressive drugs. However, long-term survival has not improved to the same extent as the short-term survival, and the 10-year survival after liver transplantation is 60%. In addition to liver- and transplant-related causes, comorbidities such as cardiovascular, pulmonary, renal, and metabolic diseases have emerged as leading causes of morbidity and mortality in liver transplant recipients. The objective of this study is to assess the burden of comorbidities and identify both liver- and transplant-related risk factors as well as traditional risk factors that contribute to the pathogenesis of comorbidity in liver transplant recipients. Methods/design The Danish Comorbidity in Liver Transplant Recipients (DACOLT) study is an observational, longitudinal study. We aim to include all adult liver transplant recipients in Denmark (n = approx. 600). Participants will be matched by sex and age to controls from the Copenhagen General Population Study (CGPS) and the Copenhagen City Heart Study (CCHS). Physical and biological measures including blood pressure, ankle–brachial index, spirometry, exhaled nitric oxide, electrocardiogram, transthoracic echocardiography, computed tomography (CT) angiography of the heart, unenhanced CT of chest and abdomen and blood samples will be collected using uniform protocols in participants in DACOLT, CGPS, and CCHS. Blood samples will be collected and stored in a research biobank. Follow-up examinations at regular intervals up to 10 years of follow-up are planned. Discussion There is no international consensus standard for optimal clinical care or monitoring of liver transplant recipients. This study will determine prevalence, incidence and risk factors for comorbidity in liver transplant recipients and may be used to provide evidence for guidelines on management, treatment and screening and thereby contribute to improvement of the long-term survival. Trial registration ClinicalTrials.gov: NCT04777032; date of registration: March 02, 2021.

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