Association of preoperative parameters with postoperative mortality and long-term survival after liver transplantation

作者：Vrochides Dionisios^*; Hassanain Mazzen; Barkun Jeffrey; Tchervenkov Jean; Paraskevas Steven; Chaudhury Prosanto; Cantarovich Marcelo; Deschenes Marc; Wong Phil; Ghali Peter; Chan Gabriel; Metrakos Peter

来源：Canadian Journal of Surgery, 2011, 54(2): 101-106.

DOI：10.1503/cjs.035909

Background: The ability of Child-Turcotte-Pugh (CTP) or Model for End-Stage Liver Disease (MELD) scores to predict recipient survival after liver transplantation is controversial. This analysis aims to identify preoperative parameters that might be associated with early postoperative mortality and long-term survival after liver transplantation.
Methods: We studied a total of 15 parameters, using both univariate and multivariate models, among adults who underwent primary liver transplantation.
Results: A total of 458 primary adult liver transplants were performed. Fifty-seven (12.44%) patients died during the first 3 postoperative months and composed the early mortality group. The remaining 401 patients composed the long-term patient survival group. The parameters that were identified through univariate analysis to be associated with early postoperative mortality were CTP score, MELD score, bilirubin, creatinine, international normalized ratio and warm ischemia time (WIT). In all multivariate models, WIT retained its statistical significance. The 10-year long-term survival was 65%. The parameters that were identified to be independent predictors of long-term survival were the recipient's sex (improved survival in women, p = 0.005), diagnosis of hepatocellular cancer (p = 0.015) and recipient's age (p = 0.024).
Conclusion: Either CTP or MELD score, in conjunction with WIT, might have a role in predicting early postoperative mortality after liver transplantation, whereas the recipient's sex and the absence of cancer are associated with improved long-term survival.

• 出版日期2011-4