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Physical Performance Decline During the Early Posttransplantation Period Affects Survival After Living Donor Liver Transplantation

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Author(s)
Deok-Gie KimShin HwangKwang-Woong LeeGyu-Seong ChoiYoung Kyoung YouJe Ho RyuBong-Wan KimYang Won NahDong-Sik KimJai Young ChoKoo Jeong KangGeun HongHee Chul YuMan Ki JuSuk-Won SuhKwan Woo KimDongho ChoiJaehong JeongSoo Jin Na ChoiJu Ik MoonJae Geun LeeMyoung Soo KimDonglak ChoiDong Jin Joo
Keimyung Author(s)
Kang, Koo Jeong
Department
Dept. of Surgery (외과학)
Journal Title
Transplantation
Issued Date
2023
Volume
16
Abstract
Background:
Patient physical performance has been emphasized in liver transplant recipients; however, evidence for living donor liver transplantation (LDLT) patients is lacking. This study investigated the impact of physical performance decline during the early posttransplantation period on survival and risk factors for this decline in LDLT recipients.

Methods:
From national registry data, 2703 LDLT patients were divided into 2 groups based on the change in their Karnofsky performance status (KPS) between 1 and 6 mo posttransplantation: declined KPS (n = 188) and control (n = 2515). Multivariable analyses were conducted to control for confounders, including posttransplantation complications.

Results:
Estimated 5-y patient survival rates were 91.6% in the declined KPS group and 96.3% in the control group, favoring the latter ( P = 0.003). The survival hazard of KPS decline was significant in a baseline covariates-adjusted Cox model (hazard ratio [HR], 2.60; 95% confidence interval [CI], 1.37-4.95) and an adjusted model accounting for posttransplantation complications (HR, 3.38; 95% CI, 1.70-6.72). In subgroup analyses, KPS decline independently reduced survival in patients without complications (HR, 3.95; 95% CI, 1.67-9.34), and the trend was similar in patients with complications, although significance was marginal (HR, 3.02; 95% CI, 0.98-9.27). We found that only posttransplantation complications, such as rejection, infection, bile duct complication, and vascular complication, were significant risk factors for KPS decline after LDLT.

Conclusions:
Physical performance decline during the early posttransplantation period independently reduced survival rates, and posttransplantation complications were the only significant risk factors for physical performance decline in LDLT recipients.
Keimyung Author(s)(Kor)
강구정
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1534-6080
Source
https://journals.lww.com/transplantjournal/Fulltext/9900/Physical_Performance_Decline_During_the_Early.326.aspx
DOI
10.1097/TP.0000000000004517
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44883
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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