BACKGROUND: Prolonged hyperbilirubinemia (HB) following living donor liver transplantation (LDLT) can be a risk factor for early graft loss and mortality. However, some recipients who present with postoperative hyperbilirubinemia do recover and maintain a good liver function. AIM: The purpose of this study was to investigate the risk factors for hyperbilirubinemia following LDLT and to identify predictors of the outcomes in patients with post-transplant hyperbilirubinemia. METHODS: A total of 107 consecutive adults who underwent LDLT in Nagasaki University Hospital were investigated retrospectively. The patients were divided into two groups according to postoperative peak serum bilirubin level (HB group: ≥ 30 mg/dl; non-HB group: <30 mg/dl). These two groups of patients and the prognosis of patients in the HB group were analyzed using several parameters. RESULTS: Seventeen patients (15.9 %) presented with hyperbilirubinemia, and their overall survival was significantly worse than patients in the non-HB group (n = 90). Donor age was significantly higher in the HB group (P < 0.05). Of the 17 patients in the HB group, nine survived. The postoperative serum prothrombin level at the time when the serum bilirubin level was >30 mg/dl was significantly higher in surviving patients (P < 0.01). CONCLUSIONS: The use of a partial liver graft from an aged donor is a significant risk factor for severe hyperbilirubinemia and a poorer outcome. However, those patients who maintain their liver synthetic function while suffering from hyperbilirubinemia may recover from hyperbilirubinemia and eventually achieve good liver function, thus resulting in a favorable survival.
BACKGROUND: Prolonged hyperbilirubinemia (HB) following living donor liver transplantation (LDLT) can be a risk factor for early graft loss and mortality. However, some recipients who present with postoperative hyperbilirubinemia do recover and maintain a good liver function. AIM: The purpose of this study was to investigate the risk factors for hyperbilirubinemia following LDLT and to identify predictors of the outcomes in patients with post-transplant hyperbilirubinemia. METHODS: A total of 107 consecutive adults who underwent LDLT in Nagasaki University Hospital were investigated retrospectively. The patients were divided into two groups according to postoperative peak serum bilirubin level (HB group: ≥ 30 mg/dl; non-HB group: <30 mg/dl). These two groups of patients and the prognosis of patients in the HB group were analyzed using several parameters. RESULTS: Seventeen patients (15.9 %) presented with hyperbilirubinemia, and their overall survival was significantly worse than patients in the non-HB group (n = 90). Donor age was significantly higher in the HB group (P < 0.05). Of the 17 patients in the HB group, nine survived. The postoperative serum prothrombin level at the time when the serum bilirubin level was >30 mg/dl was significantly higher in surviving patients (P < 0.01). CONCLUSIONS: The use of a partial liver graft from an aged donor is a significant risk factor for severe hyperbilirubinemia and a poorer outcome. However, those patients who maintain their liver synthetic function while suffering from hyperbilirubinemia may recover from hyperbilirubinemia and eventually achieve good liver function, thus resulting in a favorable survival.
Authors: T Ikegami; T Nishizaki; K Yanaga; M Shimada; K Kishikawa; K Nomoto; H Uchiyama; K Sugimachi Journal: Transplantation Date: 2000-12-27 Impact factor: 4.939
Authors: Ramón Rull; Oscar Vidal; Dulce Momblan; Francisco Xavier González; Miguel Angel López-Boado; Jose Fuster; Luis Grande; Miguel Bruguera; Katiana Cabrer; Juan Carlos García-Valdecasas Journal: Liver Transpl Date: 2003-04 Impact factor: 5.799
Authors: Andrew M Cameron; Rafik M Ghobrial; Jonathan R Hiatt; Ian C Carmody; Sherilyn A Gordon; Douglas G Farmer; Hasan Yersiz; Michael A Zimmerman; Francisco Durazo; Steve H Han; Sammy Saab; Jeffrey Gornbein; Ronald W Busuttil Journal: Ann Surg Date: 2006-10 Impact factor: 12.969
Authors: T Kiuchi; M Kasahara; K Uryuhara; Y Inomata; S Uemoto; K Asonuma; H Egawa; S Fujita; M Hayashi; K Tanaka Journal: Transplantation Date: 1999-01-27 Impact factor: 4.939
Authors: Yousri M Barri; Edmund Q Sanchez; Linda W Jennings; Larry B Melton; Steven Hays; Marlon F Levy; Goran B Klintmalm Journal: Liver Transpl Date: 2009-05 Impact factor: 5.799