Risk Factors for Short- and Long-Term Mortality in Liver Transplant Recipients with MELD Score ≥30

2015 ◽  
Vol 20 ◽  
pp. 59-69 ◽  
Author(s):  
Harald Schrem
Keyword(s):  
Risk Factors ◽  
Liver Transplant ◽  
Meld Score ◽  
Transplant Recipients ◽  
Short And Long Term ◽  
Liver Transplant Recipients ◽  
Long Term Mortality

scholarly journals The Danish comorbidity in liver transplant recipients study (DACOLT): a non-interventional prospective observational cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Magda Teresa Thomsen ◽  
Julie Høgh ◽  
Andreas Dehlbæk Knudsen ◽  
Anne Marie Reimer Jensen ◽  
Marco Gelpi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplant ◽  
Transplant Recipients ◽  
Short Term ◽  
Term Survival ◽  
Blood Samples ◽  
Liver Transplant Recipients ◽  
Short Term Survival

Abstract Background Liver transplantation is the only curative treatment for patients with end-stage liver disease. Short-term survival has improved due to improved surgical techniques and greater efficacy of immunosuppressive drugs. However, long-term survival has not improved to the same extent as the short-term survival, and the 10-year survival after liver transplantation is 60%. In addition to liver- and transplant-related causes, comorbidities such as cardiovascular, pulmonary, renal, and metabolic diseases have emerged as leading causes of morbidity and mortality in liver transplant recipients. The objective of this study is to assess the burden of comorbidities and identify both liver- and transplant-related risk factors as well as traditional risk factors that contribute to the pathogenesis of comorbidity in liver transplant recipients. Methods/design The Danish Comorbidity in Liver Transplant Recipients (DACOLT) study is an observational, longitudinal study. We aim to include all adult liver transplant recipients in Denmark (n = approx. 600). Participants will be matched by sex and age to controls from the Copenhagen General Population Study (CGPS) and the Copenhagen City Heart Study (CCHS). Physical and biological measures including blood pressure, ankle–brachial index, spirometry, exhaled nitric oxide, electrocardiogram, transthoracic echocardiography, computed tomography (CT) angiography of the heart, unenhanced CT of chest and abdomen and blood samples will be collected using uniform protocols in participants in DACOLT, CGPS, and CCHS. Blood samples will be collected and stored in a research biobank. Follow-up examinations at regular intervals up to 10 years of follow-up are planned. Discussion There is no international consensus standard for optimal clinical care or monitoring of liver transplant recipients. This study will determine prevalence, incidence and risk factors for comorbidity in liver transplant recipients and may be used to provide evidence for guidelines on management, treatment and screening and thereby contribute to improvement of the long-term survival. Trial registration ClinicalTrials.gov: NCT04777032; date of registration: March 02, 2021.

scholarly journals Pretransplant Fasting Glucose Predicts New-Onset Diabetes after Liver Transplantation

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Elizabeth J. Carey ◽  
Bashar A. Aqel ◽  
Thomas J. Byrne ◽  
David D. Douglas ◽  
Jorge Rakela ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplant ◽  
Fasting Glucose ◽  
Meld Score ◽  
Transplant Recipients ◽  
Onset Diabetes ◽  
The Mean ◽  
One Year ◽  
Liver Transplant Recipients ◽  
New Onset

New-onset diabetes after transplantation (NODAT) is common after liver transplant and associated with poorer outcomes. The aim of this study was to identify risk factors for NODAT in liver transplant recipients off corticosteroids. In 225 adult nondiabetic liver transplant recipients, the mean age was 51.7 years, the majority were men (71%), and half had HCV (49%). The mean calculated MELD score at transplantation was 18.7, and 19% underwent living-donor transplant (LDLT). One year after transplantation, 17% developed NODAT, and an additional 16% had impaired fasting glucose. The incidence of NODAT in patients with HCV was 26%. In multivariate analysis, HCV, pretransplant FPG, and LDLT were significant. Each 10 mg/dL increase in pretransplant FPG was associated with a twofold increase in future development of NODAT. The incidence of NODAT after liver transplant in patients off corticosteroids is 17%. Risk factors for developing NODAT include HCV and pretransplant FPG; LDLT is protective.

scholarly journals Peritoneal Dialysis After Liver Transplantation: A Systematic Review

2021 ◽  
Vol 8 ◽  
pp. 205435812110297
Author(s):  
Jean Maxime Côté ◽  
Isabelle Ethier ◽  
Héloïse Cardinal ◽  
Marie-Noëlle Pépin
Keyword(s):  
Systematic Review ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Kidney Failure ◽  
Liver Graft ◽  
Transplant Recipients ◽  
Technique Survival ◽  
Liver Transplant Recipients

Background: Chronic kidney disease following liver transplantation is a major long-term complication. Most liver transplant recipients with kidney failure will be treated with dialysis instead of kidney transplantation due to noneligibility and shortage in organ availability. In this population, the role of peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) remains unclear. Objective: To determine the feasibility regarding safety, technique survival, and dialysis efficiency of PD in liver transplant recipients requiring KRT for maintenance dialysis. Design: Systematic review. Setting: Interventional and observational studies reporting the use of PD after liver transplantation. Patients: Adult liver transplant recipients with kidney failure treated with maintenance KRT. Measurements: Extracted data included eligibility criteria, study design, demographics, and PD modality. The following outcomes of interest were extracted: rate of peritonitis and microorganisms involved, noninfectious peritoneal complications, technique survival, and kidney transplantation-censored technique survival. Non-PD complications included overall survival, liver graft dysfunction, and hospitalization rate. Methods: The following databases were searched until July 2020: MedLine/PubMed, EMBASE, CINAHL, and Cochrane Library. Two reviewers independently screening all titles and abstracts of all identified articles. Due to the limited sample size, observational designs and study heterogeneity expected, no meta-analysis was pre-planned. Descriptive statistics were used to report all results. Results: From the 5263 identified studies, 4 were included in the analysis as they reported at least 1 outcome of interest on a total of 21 liver transplant recipients, with an overall follow-up duration on PD of 19.0 (Interquartile range [IQR]: 9.5-29.5) months. Fifteen episodes of peritonitis occurred in a total cumulative PD follow-up of 514 patient-months, representing an incidence rate of 0.35 per year. These episodes did not result in PD technique failure, mortality, or impairment of liver graft function. Limitations: Limitations include the paucity of studies in the field and the small number of patients included in each report, a risk of publication bias and the impossibility to directly compare hemodialysis to PD in this population. These results, therefore, must be interpreted with caution. Conclusions: Based on limited data reporting the feasibility of PD in liver transplant recipients with kidney failure, no signal was associated with an increased risk of infectious complications. Long-term studies evaluating this modality need to be performed. Registration (PROSPERO): CRD42020218374.

scholarly journals Risk factors predicting Cytomegalovirus infection in post liver transplant recipients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M G Abdelrahman ◽  
H A Mahmoud ◽  
M K Mohsen ◽  
M O Ali ◽  
A M N Mohamed
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Organ Transplantation ◽  
Chronic Rejection ◽  
Cytomegalovirus Infection ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Donor Liver Transplantation ◽  
Liver Transplant Recipients

Abstract Background Liver transplantation is considered to be the only curative treatment for patients with end stage liver disease. Postoperative infection remains to be one of the most common causes of morbidity and mortality throughout the past years. Cytomegalovirus (CMV) infection although considered to be a weak viral infection that usually passes asymptomatic in immunocompetent patients, however, it is considered one of the most common pathogens causing morbidities and mortality in liver transplant recipients. Multiple studies have been done to assess the risk factors for developing CMV infection. Objective Identification of risk factors predicting Cytomegalovirus infection in liver transplant recipients following transplantation. Methods This retrospective study was conducted on 194 patients and their donors who underwent living donor liver transplantation operation at Ain Shams centre for organ transplantation (ASCOT) at Ain Shams specialized hospital in the period between January 2010 and December 2016 with at least one year follow up period after operation for the recipient group. Results In our study, 194 patients undergoing liver transplantation at Ain shams centre for organ transplantation over seven years from January 2010 to December 2016 have been followed to assess risk factors affecting CMV infection development. Chronic rejection was found to be the most common factor associated with CMV infection followed by Cyclosporin (Neoral) as main postoperative immunosuppressant following liver transplantation. Other factors that were found to carry risk for CMV infection included younger age, advanced MELD score, positive CMV IgM status of the donors and recipients. Conclusion Differentiation of Cytomegalovirus disease from Cytomegalovirus infection isn’t always available as it requires tissue invasive techniques. Multiple risk factors have been attributed to cause Cytomegalovirus infection (viremia) . In our study, rejection (chronic rejection) was the factor that carries highest risk for Cytomegalovirus infection development followed by Cyclosporin .

LONG TERM FOLLOW UP OF 22 OPERATIONAL TOLERANT LIVER TRANSPLANT RECIPIENTS.

2010 ◽  
Vol 90 ◽  
pp. 33
Author(s):  
P. tryphonopoulos ◽  
P. Ruiz ◽  
D. Weppler ◽  
D. Levi ◽  
S. Nishida ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Transplant Recipients ◽  
Long Term Follow Up ◽  
Liver Transplant Recipients
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