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Prognostic factors predicting poor outcome in living-donor liver transplantation for fulminant hepatic failure

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Affiliated Author(s)
김태석
Alternative Author(s)
Kim, Tae Seok
Journal Title
Tansplantation Proceedings
ISSN
0041-1345
Issued Date
2017
Abstract
Background. Living-donor liver transplantation (LDLT) has been accepted as feasible
treatment for fulminant hepatic failure (FHF), although it has generated several debatable
issues. In this study, we investigated the prognostic factors predicting fatal outcome after
LDLT for FHF.
Methods. From April 1999 to April 2011, 60 patients underwent LT for acute liver
failure, including 42 patients for FHF at Samsung Medical Center, Seoul, Korea. Among
42 patients, 30 patients underwent LDLT for FHF, and the database of these patients was
analyzed retrospectively to investigate the prognostic factors after LDLT for FHF.
Results. Among 30 patients, 7 patients (23%) died during the in-hospital period within 6
months, and 23 patients (77%) survived until recently. In univariate analyses, donor age
(>35 years), graft volume (GV)/standard liver volume (SLV) (<50%), cold ischemic
time (>120 minutes), hepatic encephalopathy (grade IV), hepato-renal syndrome
(HRS), and history of ventilator care were associated with fatal outcome after LDLT for
FHF. In multivariate analyses, HRS, GV/SLV (<50%), and donor age (>35 years) were
significantly associated with fatal outcome. Although the statistical significance was not
shown in this analysis (P ¼ .059), hepatic encephalopathy grade IV also appears to be a
risk factor predicting fatal outcome.
Conclusions. The survival of patients with FHF undergoing LDLT was comparable to
that in published data. In this study, HRS, GV/SLV <50%, and donor age >35 years are
the independent poor prognostic factors.
Department
Dept. of Surgery (외과학)
Publisher
School of Medicine
Citation
T.-S. Kim et al. (2017). Prognostic factors predicting poor outcome in living-donor liver transplantation for fulminant hepatic failure. Tansplantation Proceedings, 49(5), 1118–1122. doi: 10.1016/j.transproceed.2017.03.031
Type
Article
ISSN
0041-1345
DOI
10.1016/j.transproceed.2017.03.031
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32862
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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