Transplantation · 2024
Preoperative Factors Affecting Graft Survival After ABO-incompatible Adult Liver Transplantation.
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Nam Hyun-Jun, Kim Deok-Gie, Min Eun-Ki, Lee Jae Geun, Han Dai Hoon, Kim Sinyoung, Lee Kyung-A, Choi Gi Hong, Joo Dong Jin, Kim Hyun Ok, Kwon Soon Sung, Kim Myoung Soo
Аннотация
BACKGROUND: Although ABO-incompatible liver transplantation (ABOi LT) has undergone remarkable progress, the prognostic factors are poorly understood. This study aimed to elucidate the preoperative factors affecting graft survival after ABOi LT.
METHODS: Patients who underwent ABOi LT between January 2012 and December 2020 at a single institution in South Korea were retrospectively reviewed. A total of 146 recipients, including 34 patients with graft loss, were analyzed.
RESULTS: In the multivariate Cox proportional hazard model, recipient age (≥55 y; hazard ratio, 2.47; 95% confidence interval, 1.18-5.19; P = 0.017) and donor ABO type (donor A, hazard ratio, 3.12; 95% confidence interval, 1.33-7.33; P = 0.009) were significantly associated with an increased risk of graft loss. The most common cause of graft loss was recipient death due to bacterial infection (15/34, 44.1%). Both recipient age and donor ABO type were associated with an increased risk of recipient death due to bacterial infections. The incidence of complications after ABOi LT, including antibody-mediated rejection and diffuse intrahepatic biliary stricture, did not differ according to recipient age or donor ABO type.
CONCLUSIONS: These findings suggest that recipient age and donor ABO type should be considered when preparing for ABOi LT. Careful monitoring and care after transplantation are required for recipients with preoperative risk factors.
METHODS: Patients who underwent ABOi LT between January 2012 and December 2020 at a single institution in South Korea were retrospectively reviewed. A total of 146 recipients, including 34 patients with graft loss, were analyzed.
RESULTS: In the multivariate Cox proportional hazard model, recipient age (≥55 y; hazard ratio, 2.47; 95% confidence interval, 1.18-5.19; P = 0.017) and donor ABO type (donor A, hazard ratio, 3.12; 95% confidence interval, 1.33-7.33; P = 0.009) were significantly associated with an increased risk of graft loss. The most common cause of graft loss was recipient death due to bacterial infection (15/34, 44.1%). Both recipient age and donor ABO type were associated with an increased risk of recipient death due to bacterial infections. The incidence of complications after ABOi LT, including antibody-mediated rejection and diffuse intrahepatic biliary stricture, did not differ according to recipient age or donor ABO type.
CONCLUSIONS: These findings suggest that recipient age and donor ABO type should be considered when preparing for ABOi LT. Careful monitoring and care after transplantation are required for recipients with preoperative risk factors.
Предметные рубрики MeSH
Graft SurvivalLiver TransplantationABO Blood-Group SystemBlood Group IncompatibilityPrognosisRetrospective StudiesRepublic of KoreaGraft RejectionProportional Hazards ModelsMultivariate AnalysisRisk FactorsAge FactorsTransplant RecipientsIncidenceConstriction, PathologicHumansMaleFemaleYoung AdultAdultMiddle AgedCarcinoma, HepatocellularLiver NeoplasmsLiver CirrhosisSeverity of Illness Index