Study of re-transplantation and prognosis in liver transplant center in Iran
Gastroenterology and Hepatology from Bed to Bench,
26 April 2021
Background: due to the problem of organ shortage and high demand of liver transplantation among patients, this problem has been exacerbated, thus providing more information on the causes of liver re-transplantation and its prognosis and other related issues to this procedure is of great importance. The aim of this study was to investigate the causes of liver re-transplantation in patients referred to Imam Khomeini Hospital Liver Transplantation Center and also the prognosis of this re-transplantation.
Methods: This study was conducted in 2018 as a historical cohort. In this study, the records of liver transplantation patients at Imam Khomeini Hospital Liver Transplantation Center between 2000 to 2016 and were studied. Required data were extracted from the records of patients undergoing liver transplantation. Patients' data were entered SPSS 20 software and analyzed.
Results: In this study 1030 patients with mean age of 43.15 ± 14.57 years were studied. There were 426 women (41.4%) and 604 men (58.6%). The number of primary transplants was 966 with a mean age of 43.19 ± 14.72 and the number of re-transplants 64 with a mean age of 42.56 ± 12.82. Significant differences were found between the two groups in terms of MELD and CHILD scores, cold ischemic time, total and direct bilirubin levels, liver function factors (ALT, AST, and alkaline phosphatase), hemoglobin, and WBC. There was no significant difference between the two groups in terms of age, sex and platelets (> 0.05). The mortality rate was 241 (23.39%) in all patients and the mortality rate was 206 (21.32%) and in liver transplant patients was 35 (54.68%). The mortality rate in the transplant group was statistically higher (> 0.001). Secondary is primary non-functional graft (PNF) (37.5%) with 1, 3- and 5-years survival rates of 82%, 81% and 70% in primary group and 59%, 43% and 32% in re-transplantation. There was a significant difference in survival between the two groups (P <0.05). Hemoglobin and alkaline phosphatase were predictors of survival rates in transplant patients.
Conclusion: The results of this study showed that survival rate in re-transplant patients was significantly lower than primary transplant and mortality rate in re-transplant patients was significantly higher.
Key words: liver re-transplant; prognosis; Survival
- liver re-transplant
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