A critical analysis of early death after adult liver transplants

Abbas Rana, Bruce Kaplan, Tun Jie, Marian Porubsky, Shahid Habib, Horacio Rilo, Angelika C. Gruessner, Rainer W.G. Gruessner

    Research output: Contribution to journalArticle

    9 Scopus citations

    Abstract

    Introduction: The 15% mortality rate of liver transplant recipients at one yr may be viewed as a feat in comparison with the waiting list mortality, yet it nonetheless leaves room for much improvement. Our aim was to critically examine the mortality rates to identify high-risk periods and to incorporate cause of death into the analysis of post-transplant survival. Methods: We performed a retrospective analysis on United Network for Organ Sharing data for all adult recipients of liver transplants from January 1, 2002 to October 31, 2011. Our analysis included multivariate logistic regression where the primary outcome measure was patient death of 49 288 recipients. Results: The highest mortality rate by day post-transplant was on day 0 (0.9%). The most significant risk factors were as follows: for one-d mortality from technical failure, intensive care unit admission odds ratio (OR 3.2); for one-d mortality from graft failure, warm ischemia >75 min (OR 5.6); for one-month mortality from infection, a previous transplant (OR 3.3); and for one-month mortality from graft failure, a previous transplant (OR 3.7). Conclusion: We found that the highest mortality rate after liver transplantation is within the first day and the first month post-transplant. Those two high-risk periods have common, as well as different, risk factors for mortality.

    Original languageEnglish (US)
    Pages (from-to)E448-E453
    JournalClinical Transplantation
    Volume27
    Issue number4
    DOIs
    StatePublished - Jul 1 2013

    Keywords

    • Cause of death
    • Liver transplantation
    • Risk factors
    • Survival

    ASJC Scopus subject areas

    • Transplantation

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  • Cite this

    Rana, A., Kaplan, B., Jie, T., Porubsky, M., Habib, S., Rilo, H., Gruessner, A. C., & Gruessner, R. W. G. (2013). A critical analysis of early death after adult liver transplants. Clinical Transplantation, 27(4), E448-E453. https://doi.org/10.1111/ctr.12186