The effect of prior upper abdominal surgery on outcomes after liver transplantation for hepatocellular carcinoma: An analysis of the database of the organ procurement transplant network

• Published in: Surgery 2018-05, Vol.163 (5), p.1028-1034
• Main Authors: Silva, Jack P., Berger, Nicholas G., Yin, Ziyan, Liu, Ying, Tsai, Susan, Christians, Kathleen K., Clarke, Callisia N., Mogal, Harveshp, Gamblin, T. Clark
• Format: Article
• Language: English
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2017.10.072

Orthotopic liver transplantation (OLT) is the preferred treatment for hepatocellular carcinoma (HCC) in select patients. Many patients listed for OLT have a history of prior upper abdominal surgery (UAS). Repeat abdominal surgery increases operative complexity and may cause a greater incidence of complication. This study sought to compare outcomes after liver transplantation for patients with and without prior UAS. Adult HCC patients undergoing OLT were identified using the database from the Organ Procurement and Transplantation Network (1987–2015). Patients were separated by presence of prior UAS into 2 propensity-matched cohorts. Overall survival (OS) and graft survival (GS) were analyzed by log-rank test and graphed using Kaplan-Meier method. Recipient and donor demographic and clinical characteristics were also studied using Cox regression models. A total of 15,043 patients were identified, of whom 6,205 had prior UAS (41.2%). After 1:1 propensity score matching, cohorts (UAS versus no UAS) contained 4,669 patients. UAS patients experienced shorter GS (122 months vs 129 months; P