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Complications and Their Resolution in Recipients of Deceased and Living Donor Liver Transplants: Findings From the A2ALL Cohort Study. Am J Transplant 2016 Feb;16(2):594-602

Date

10/16/2015

Pubmed ID

26461803

Pubmed Central ID

PMC4733444

DOI

10.1111/ajt.13479

Scopus ID

2-s2.0-84957991589   20 Citations

Abstract

The purpose of this study was to explore long-term complications in recipients of deceased donor liver transplant (DDLT) and living donor liver transplant (LDLT) in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). We analyzed 471 DDLTs and 565 LDLTs from 1998 to 2010 that were followed up to 10 years for 36 categories of complications. Probabilities of complications and their resolutions were estimated using the Kaplan-Meier method, and predictors were tested in Cox proportional hazards models. Median follow-up for DDLT and LDLT was 4.19 and 4.80 years, respectively. DDLT recipients were more likely to have hepatocellular carcinoma and higher disease severity, including Model for End-Stage Liver Disease score. Complications occurring with higher probability in LDLT included biliary-related complications and hepatic artery thrombosis. In DDLT, ascites, intra-abdominal bleeding, cardiac complications and pulmonary edema were significantly more probable. Development of chronic kidney disease stage 4 or 5 was less likely in LDLT recipients (hazard ratio [HR] 0.41, pā€‰=ā€‰0.02). DDLT and LDLT had similar risk of grade 4 complications (HR 0.89, pā€‰=ā€‰0.60), adjusted for other risk factors. Once a complication occurred, the time to resolution did not differ between LDLT and DDLT. Future efforts should be directed toward reducing the occurrence of complications after liver transplantation.

Author List

Samstein B, Smith AR, Freise CE, Zimmerman MA, Baker T, Olthoff KM, Fisher RA, Merion RM

Author

Michael A. Zimmerman MD, FACS Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Cadaver
End Stage Liver Disease
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Liver Transplantation
Living Donors
Male
Middle Aged
Postoperative Complications
Prognosis
Risk Factors
Transplant Recipients
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0