scholarly journals Results of Adult Living Donor Liver Transplantation with Sixth-Decade Donors: A Propensity Score Matching Study in a High-Volume Institution

2018 ◽  
Vol 23 ◽  
pp. 802-807 ◽  
Author(s):  
Seok-Hwan Kim ◽  
Gil-Chun Park ◽  
Shin Hwang ◽  
Chul-Soo Ahn ◽  
Ki-Hum Kim ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
High Volume ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Sixth Decade

scholarly journals Predictive utility of fibrinogen in acute kidney injury in living donor liver transplantation: A propensity score-matching analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252715
Author(s):  
Jaesik Park ◽  
Min A. Joo ◽  
Ho Joong Choi ◽  
Sang Hyun Hong ◽  
Chul Soo Park ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Acute Kidney Injury ◽  
Propensity Score ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Fibrinogen Level ◽  
Kidney Injury ◽  
Emergency Operation ◽  
Donor Liver ◽  
Donor Liver Transplantation

Background This study investigated the association between the fibrinogen level and the risk of acute kidney injury (AKI) in patients who have undergone living donor liver transplantation (LDLT). Patients and methods A total of 676 patients who underwent LDLT were analyzed retrospectively. Exclusion criteria included a history of severe kidney dysfunction, emergency operation, deceased donor, ABO-incompatible transplantation, and missing data. The study population was divided into low and normal fibrinogen groups. A 1:1 propensity score (PS) matching analysis was used to evaluate the association between a low fibrinogen level (< 160 mg/dL) and postoperative development of AKI. Results In total, 142 patients (23.1%) developed AKI after LDLT. The PS matching analysis showed that the probability of AKI was two-fold higher in the low fibrinogen group than in the normal fibrinogen group. In addition, patients with AKI had poorer postoperative outcomes such as longer hospitalization, longer ICU stay, and higher mortality than patients without AKI. Conclusions The preoperative fibrinogen level may be useful for risk stratification of patients undergoing LDLT in terms postoperative development of AKI.

scholarly journals Living Donor Liver Transplantation for Budd-Chiari Syndrome: A Propensity Score-Matched Analysis

2021 ◽  
Author(s):  
Vasanthakumar Gunasekaran ◽  
Mettu Srinivas Reddy ◽  
Ashwin Rammohan ◽  
Naresh P Shanmugam ◽  
Deepashree Thirchunapalli ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Risk Factor ◽  
Propensity Score ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Budd Chiari Syndrome ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Transfusion Requirements ◽  
Chiari Syndrome

Introduction: There are unique technical and management challenges associated with living donor liver transplantation (LDLT) for Budd-Chiari Syndrome (BCS). The outcomes of LDLT for BCS in comparison to other indications remains unclear and warrants elucidation. Methods: Data of 24 BCS patients who underwent LDLT between January 2012 and June 2019 were analyzed. There were 20 adults and 4 children. The early and long-term outcomes of adult LDLT BCS patients were compared to a control group of LDLT patients for other indications and matched using propensity scoring methodology. Results: Primary BCS was observed in 22(91.7%) patients. Caval replacement was performed in 7(29.1%) patients. Early and late hepatic venous outflow tract (HVOT) complications were seen in 1(5.5%) and 3(16.7%) patients. Preoperative acute kidney injury was identified as a risk factor for mortality in the BCS cohort (p =0.013). On comparison, BCS recipients were younger with fewer comorbidities, more large volume ascites and higher rates of PVT. They also had longer cold ischemia time, increased blood loss and transfusion requirements, increased hospital stay, and higher late outflow complications. The 1-year and 3-year survivals were similar to non-BCS cohort (84.2% vs 94% and 70% vs 91.9%, respectively, log rank test p=0.09). Conclusion: LDLT is remains a good option for symptomatic BCS who have failed non-transplant interventions. The clinical and risk factor profile of BCS recipients is distinct from non-BCS recipients. By following an algorithmic management protocol, we show on propensity-score matched analysis that outcomes of LDLT for BCS are similar to non-BCS indications.

scholarly journals Stress burden related to postreperfusion syndrome may aggravate hyperglycemia with insulin resistance during living donor liver transplantation: A propensity score-matching analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243873
Author(s):  
Sumin Chae ◽  
Junghee Choi ◽  
Sujin Lim ◽  
Ho Joong Choi ◽  
Jaesik Park ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Liver Transplantation ◽  
Propensity Score ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Plasma Concentrations ◽  
Donor Liver ◽  
C Peptide ◽  
Donor Liver Transplantation ◽  
The Impact

Background We investigated the impact of postreperfusion syndrome (PRS) on hyperglycemia occurrence and connecting (C) peptide release, which acts as a surrogate marker for insulin resistance, during the intraoperative period after graft reperfusion in patients undergoing living donor liver transplantation (LDLT) using propensity score (PS)-matching analysis. Patients and methods Medical records from 324 adult patients who underwent elective LDLT were retrospectively reviewed, and their data were analyzed according to PRS occurrence (PRS vs. non-PRS groups) using the PS-matching method. Intraoperative levels of blood glucose and C-peptide were measured through the arterial or venous line at each surgical phase. Hyperglycemia was defined as a peak glucose level >200 mg/dL, and normal plasma concentrations of C-peptide in the fasting state were taken to range between 0.5 and 2.0 ng/mL. Results After PS matching, there were no significant differences in pre- and intra-operative recipient findings and donor-graft findings between groups. Although glucose and C-peptide levels continuously increased through the surgical phases in both groups, glucose and C-peptide levels during the neohepatic phase were significantly higher in the PRS group than in the non-PRS group, and larger changes in levels were observed between the preanhepatic and neohepatic phases. There were higher incidences of C-peptide levels >2.0 ng/mL and peak glucose levels >200 mg/dL in the neohepatic phase in patients with PRS than in those without. PRS adjusted for PS with or without exogenous insulin infusion was significantly associated with hyperglycemia occurrence during the neohepatic phase. Conclusions Elucidating the association between PRS and hyperglycemia occurrence will help with establishing a standard protocol for intraoperative glycemic control in patients undergoing LDLT.

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