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KMID : 0371420180950050267
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Annals of Surgical Treatment and Research
2018 Volume.95 No. 5 p.267 ~ p.277
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Clinical outcome of 1,000 consecutive cases of liver transplantation: a single center experience
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Kwak Bong-Jun
Kim Dong-Goo
Han Jae-Hyun
Choi Ho-Joong
Bae Si-Hyun
You Young-Kyoung
Choi Jong-Young
Yoon Seung-Kew
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Abstract
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Purpose: The aim of this study was to analyze survival outcomes in 1,000 consecutive liver transplantations (LTs) performed at a single institution from 1993 to April 2017.
Methods: The study population was divided into 2 groups based on donor type: deceased donor LT (DDLT; n = 181, 18.1%) and living donor LT (LDLT; n = 819; 81.9%), and into 3 periods based on the number of cases (first 300 cases, middle 300 cases, last 400 cases).
Results: Infection was the most common cause of death, accounting for 34.8% (95 of 273). Mortality due to hepatocellular carcinoma recurrence occurred most frequently between 1 and 5 years after transplantation. Mortality rate by graft rejection was highest between 5 and 10 years after transplantation. And mortality by de novo malignancy occurred most frequently after 10 years after transplantation. The patient survival rates for the entire population at 5 and 10 years were 74.7%, and 68.6%, respectively. There was no difference in survival rate between the LDLT and DDLT groups (P = 0.188). Cause of disease, disease severity, case period, and retransplantation had a significant association with patient survival (P = 0.002, P = 0.031, P = 0.003, and P = 0.024, respectively).
Conclusion: Surgical techniques and perioperative management for transplant patients have improved and undergone standardization. Controlling perioperative infection and managing patients with HCC as LT candidates will result in better outcomes.
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KEYWORD
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Liver transplantation, Cause of death, Survival, Risk factors
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