Outcomes of Early Postoperative Stay in the Intensive Care Unit and Rehabilitation Requirements in Liver Transplant Recipients With Hepatocellular Carcinoma Versus Decompensated Cirrhosis.

OBJECTIVES

This study compared early postoperative duration of stay in the intensive care unit and rehabilitation requirements between patients with hepatocellular carcinoma and patients with decom-pensated cirrhosis after liver transplant.

MATERIALS AND

METHODS

Patients were divided into 3 groups: hepatocellular carcinoma with mild-to-mode-rate cirrhosis, hepatocellular carcinoma with severe cirrhosis, and decompensated cirrhosis. We collected data on demographics and etiology, Child-Pugh classification, preoperative blood and biochemical profiles, cardiopulmonary function, and postoperative recovery milestones (eg, extubation time, drain removal, catheter removal, first bowel movement). We also obtained data on quadriceps muscle strength, rehabilitation sessions, and duration of stay in the intensive care unit. We conducted comparative analyses among groups and used linear regression to identify factors influencing stay duration in the intensive care unit.

RESULTS

Our study included 110 liver transplant patients. Preoperatively, the decompensated cirrhosis group had the highest proportion of patients with Child-Pugh class C and disease duration of >3 years. Postoperatively, groups with hepatocellular carcinoma had earlier weaning, catheter, and drain removal compared with the decompensated cirrhosis group, which had longer stays in the intensive care unit and more rehabilitation sessions. Regression analysis showed that preoperative total bilirubin and albumin levels and postoperative drain and catheter removal times were the main determinants of stay duration in the intensive care unit.

CONCLUSIONS

Patients with hepatocellular carcinoma had better preoperative conditions, leading to faster postoperative recovery, shorter stays in the intensive care unit, and reduced rehabilitation requirements compared with those with decompensated cirrhosis. Etiology-specific recovery patterns and predictive models support individualized rehabilitation management.