Evaluation of liver transplantation for high-risk indications

Background Appropriate use of orthotopic liver transplantation (OLT) requires continued assessment of the indications for transplantation as a number of diseases are associated with a poor prognosis. High‐risk patients are those who have a poor survival or high incidence of recurrent disease (patien...

Full description

Saved in:
Bibliographic Details
Published in:British journal of surgery 1997-02, Vol.84 (2), p.189-195
Main Authors: Chung, S. W., Greig, P. D., Cattral, M. S., Taylor, B. R., Sheiner, P. A., Wanless, I., Cameron, R., Phillips, M. J., Blendis, L. M., Langer, B., Levy, G. A.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Graft Survival
Hepatic Encephalopathy - surgery
Hepatitis B - surgery
Hepatitis C - surgery
Humans
Liver Neoplasms - surgery
Liver Transplantation - mortality
Liver, biliary tract, pancreas, portal circulation, spleen
Medical sciences
Middle Aged
Recurrence
Reoperation
Retrospective Studies
Risk Factors
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Survival Analysis
Survival Rate
Time Factors
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Appropriate use of orthotopic liver transplantation (OLT) requires continued assessment of the indications for transplantation as a number of diseases are associated with a poor prognosis. High‐risk patients are those who have a poor survival or high incidence of recurrent disease (patients with tumours, hepatitis B‐ or hepatitis C‐induced cirrhosis, fulminant hepatic failure or primary graft non‐function). In addition, retransplantation may be associated with a poor outcome. Methods A retrospective review was made of the records of all adult patients undergoing OLT at this hospital between October 1985 and July 1994. Results A total of 396 liver transplants were performed in 364 patients. The 1– and 3–year actuarial survival rates were 82 and 69 per cent respectively. The overall survival rate of high‐risk patients was significantly lower than that for all OLT recipients (P < 0.05). While no patients transplanted for hepatitis C have developed graft failure, recurrent hepatitis occurred in 15 of 35 patients. Conclusion Strict selection criteria and appropriate perioperative investigations and interventions are required to improve the results of OLT in these high‐risk patients.
ISSN:0007-1323
1365-2168
DOI:10.1046/j.1365-2168.1997.02488.x