Source:http://linkedlifedata.com/resource/pubmed/id/19399732
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
5
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| pubmed:dateCreated |
2009-5-4
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| pubmed:abstractText |
Although adult-to-adult living donor liver transplantation (ALDLT) has shown comparable outcomes to deceased donor liver transplantation, the outcome of patients with a high MELD score (>25) and a small-for-size graft (SFSG<0.8% of graft-to-recipient weight ratio) is not known. For 7 years, 167 consecutive hepatitis B virus-infected recipients underwent ALDLT at our institution. Based on their MELD score without additional score for hepatocellular carcinoma (HCC), the recipients were divided into Group L (low MELD score, n = 105) or Group H (high MELD score, n = 62). To analyze the risk of the graft size, the patients were further stratified as follows: Group Hs (high MELD score and SFSG, n = 11), Hn (high MELD score and normal size graft, n = 51), Ls (low MELD score and SFSG, n = 18), and Ln (low MELD score and normal size graft, n = 87). The primary endpoint was one-year patient survival rate (1-YSR). The mean follow-up period was 32.6 months. The mean MELD scores were 17.1 in Group L and 32.6 in Group H. Group H had more patients with the complications of cirrhosis but less patients with HCC than Group L (p < 0.05). However, major morbidity rates and 1-YSR were similar in comparisons between Group L (46.7% and 86.7%) and H (59.7% and 83.8%) (p > 0.05). 1-YSR was similar among Group Hs (72.7%), Hn (86.3%), Ls (83.3%), and Ln (88.5%) groups (p = 0.278). The multivariate analysis revealed accompanying HCC and the year of transplant were risk factors for poor 1-YSR. However, 1-YSR without HCC patients was also similar in comparisons between group L (90.2%) and H (91.7%) (p = 0.847), and among Group Hs (80.0%), Hn (94.7%), Ls (72.7%), and Ln (96.7%) (p = 0.072). In conclusion, high MELD score (>25) didn't predict 1-YSR in ALDLT. Improvement of the 1-YSR might be affected by center's experience as well as the selection of patients with low risk of recurrence of HCC.
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| pubmed:commentsCorrections | |
| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
May
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| pubmed:issn |
1527-6473
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| pubmed:author | |
| pubmed:issnType |
Electronic
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| pubmed:volume |
15
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
496-503
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| pubmed:dateRevised |
2010-11-18
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| pubmed:meshHeading |
pubmed-meshheading:19399732-Adolescent,
pubmed-meshheading:19399732-Adult,
pubmed-meshheading:19399732-Aged,
pubmed-meshheading:19399732-Carcinoma, Hepatocellular,
pubmed-meshheading:19399732-Female,
pubmed-meshheading:19399732-Graft Rejection,
pubmed-meshheading:19399732-Graft Survival,
pubmed-meshheading:19399732-Hepatitis B,
pubmed-meshheading:19399732-Hospital Mortality,
pubmed-meshheading:19399732-Humans,
pubmed-meshheading:19399732-Kaplan-Meier Estimate,
pubmed-meshheading:19399732-Korea,
pubmed-meshheading:19399732-Liver,
pubmed-meshheading:19399732-Liver Cirrhosis,
pubmed-meshheading:19399732-Liver Neoplasms,
pubmed-meshheading:19399732-Liver Transplantation,
pubmed-meshheading:19399732-Living Donors,
pubmed-meshheading:19399732-Male,
pubmed-meshheading:19399732-Middle Aged,
pubmed-meshheading:19399732-Organ Size,
pubmed-meshheading:19399732-Proportional Hazards Models,
pubmed-meshheading:19399732-Retrospective Studies,
pubmed-meshheading:19399732-Risk Assessment,
pubmed-meshheading:19399732-Severity of Illness Index,
pubmed-meshheading:19399732-Time Factors,
pubmed-meshheading:19399732-Treatment Outcome,
pubmed-meshheading:19399732-Young Adult
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| pubmed:year |
2009
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| pubmed:articleTitle |
Improved outcome of adult recipients with a high model for end-stage liver disease score and a small-for-size graft.
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| pubmed:affiliation |
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
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| pubmed:publicationType |
Journal Article
|