Jong Man Kim1, Deok Gie Kim2, Jihyun Kim3, Keunsung Lee3, Kwang-Woong Lee4, Je Ho Ryu5, Bong-Wan Kim6, Dong Lak Choi7, Young Kyoung You8, Dong-Sik Kim9, Yang Won Nah10, Koo Jeong Kang11, Jai Young Cho12, Geun Hong12, Hee Chul Yu13, Ju Ik Moon14, Dongho Choi15, Shin Hwang16, Myoung Soo Kim17. 1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 2. Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea. 3. Novartis Korea Ltd., Seoul, Korea. 4. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. 5. Division of Hepato-Biliary-Pancreatic Surgery and liver Transplantation, Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea. 6. Department of Liver Transplantation and Hepatobiliary Surgery, Ajou University School of Medicine, Suwon, Korea. 7. Department of Surgery, Catholic University of Daegu College of Medicine, Daegu, Korea. 8. Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. 9. Division of HBP Surgery & Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea. 10. Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. 11. Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. 12. Department of Surgery, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea. 13. Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea. 14. Department of Surgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea. 15. Department of Surgery, Hanyang University College of Medicine, Seoul, Korea. 16. Department of Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. 17. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Abstract
BACKGROUND/AIMS: To analyze the incidence and risk factors of outcomes after liver transplantation (LT) in the Korean population. METHODS: This study analyzed data from the liver cohort of Korean Organ Transplantation Registry (KOTRY) who had LT between May 2014 and December 2017. Study measures included the incidence of post-LT outcomes in recipients of living donor LT (LDLT) and deceased donor LT (DDLT). Cox multivariate proportional hazards model was used to determine the potential risk factors predicting the outcomes. RESULTS: A total of 2,563 adult recipients with LT (LDLT, n=1,956; DDLT, n=607) were included, with mean±standard deviation age of 53.9±8.9 years, and 72.2% were male. The post-LT outcomes observed in each LDLT and DDLT recipients were death (4.0% and 14.7%), graft loss (5.0% and 16.1%), rejection (7.0% and 12.0%), renal failure (2.7% and 13.8%), new onset of diabetes (12.5% and 15.4%), and hepatocellular carcinoma (HCC) recurrence (both 6.7%). In both LDLT and DDLT recipients, the most common post-LT complications were renal dysfunction (33.6% and 51.4%), infection (26.7% and 48.4%), and surgical complication (22.5% and 23.9%). Incidence of these outcomes were generally higher among recipients of DDLT than LDLT. Multivariate analysis indicated recipient age and DDLT as significant risk factors associated with death and graft loss. DDLT and ABO incompatible transplant were prognostic factors for rejection, and HCC beyond Milan criteria at pre-transplant was a strong predictor of HCC recurrence. CONCLUSION: This study is a good indicator of the post-LT prognosis in the Korean population and suggests a significant burden of post-LT complications.
BACKGROUND/AIMS: To analyze the incidence and risk factors of outcomes after liver transplantation (LT) in the Korean population. METHODS: This study analyzed data from the liver cohort of Korean Organ Transplantation Registry (KOTRY) who had LT between May 2014 and December 2017. Study measures included the incidence of post-LT outcomes in recipients of living donor LT (LDLT) and deceased donor LT (DDLT). Cox multivariate proportional hazards model was used to determine the potential risk factors predicting the outcomes. RESULTS: A total of 2,563 adult recipients with LT (LDLT, n=1,956; DDLT, n=607) were included, with mean±standard deviation age of 53.9±8.9 years, and 72.2% were male. The post-LT outcomes observed in each LDLT and DDLT recipients were death (4.0% and 14.7%), graft loss (5.0% and 16.1%), rejection (7.0% and 12.0%), renal failure (2.7% and 13.8%), new onset of diabetes (12.5% and 15.4%), and hepatocellular carcinoma (HCC) recurrence (both 6.7%). In both LDLT and DDLT recipients, the most common post-LT complications were renal dysfunction (33.6% and 51.4%), infection (26.7% and 48.4%), and surgical complication (22.5% and 23.9%). Incidence of these outcomes were generally higher among recipients of DDLT than LDLT. Multivariate analysis indicated recipient age and DDLT as significant risk factors associated with death and graft loss. DDLT and ABO incompatible transplant were prognostic factors for rejection, and HCC beyond Milan criteria at pre-transplant was a strong predictor of HCC recurrence. CONCLUSION: This study is a good indicator of the post-LT prognosis in the Korean population and suggests a significant burden of post-LT complications.
Authors: Hyo Jun Kim; Jai Young Cho; Ho-Seong Han; Yoo-Seok Yoon; Hae Won Lee; Jun Suh Lee; Boram Lee; Yeongsoo Jo; Meeyouong Kang; Yeshong Park; Eunhye Lee Journal: Medicina (Kaunas) Date: 2022-05-30 Impact factor: 2.948
Authors: Deok-Gie Kim; Shin Hwang; Jong Man Kim; Je Ho Ryu; Young Kyoung You; Donglak Choi; Bong-Wan Kim; Dong-Sik Kim; Yang Won Nah; Tae-Seok Kim; Jai Young Cho; Geun Hong; Jae Do Yang; Jaryung Han; Suk-Won Suh; Kwan Woo Kim; Yun Kyung Jung; Ju Ik Moon; Jun Young Lee; Sung Hwa Kim; Jae Geun Lee; Myoung Soo Kim; Kwang-Woong Lee; Dong Jin Joo Journal: J Clin Med Date: 2022-07-20 Impact factor: 4.964