Long-term Outcomes and Risk Factors after Adult Living Donor Liver Transplantation

Daisuke Imai, Tomoharu Yoshizumi, Kazuhito Sakata, Toru Ikegami, Shinji Itoh, Noboru Harada, Takashi Motomura, Takeo Toshima, Yohei Mano, Yuji Soejima, Yoshihiko Maehara

Research output: Contribution to journalArticle

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Abstract

Background Although risk factors for the long-term mortality of liver transplantation are well described, there is a lack of detailed study regarding these factors for adult living donor liver transplantation (LDLT). Methods We retrospectively analyzed 528 adult LDLT recipients in our hospital. The risk factors were analyzed for overall deaths more than 5 years post-LDLT. Results Over the 20-year follow-up, 137 patients died. Patient survival at 1, 3, 5, and 10 years post-LDLT was 87.8%, 81.8%, 79.4%, and 72.8%, respectively. The independent risk factors for more than 5 years post-LDLT overall death were hepatocellular carcinoma recurrence (hazard ratio [HR], 38.9; P < 0.001), lymphoid de novo malignancy (HR, 47.2; P = 0.001), primary sclerosing cholangitis as primary diagnosis (HR, 11.5; P < 0.001), chronic rejection (HR, 6.93; P = 0.006), acute rejection (HR, 2.96; P = 0.017), and bile duct stenosis (HR, 2.30; P = 0.045). Conclusions Not only malignancies and rejection but also bile duct stenosis and primary sclerosing cholangitis had significant impacts on late period post-LDLT mortality.

Original languageEnglish
Pages (from-to)e382-e391
JournalTransplantation
Volume102
Issue number9
DOIs
Publication statusPublished - Sep 1 2018

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Living Donors
Liver Transplantation
Sclerosing Cholangitis
Bile Ducts
Pathologic Constriction
Mortality
Hepatocellular Carcinoma
Neoplasms
Recurrence
Survival

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Long-term Outcomes and Risk Factors after Adult Living Donor Liver Transplantation. / Imai, Daisuke; Yoshizumi, Tomoharu; Sakata, Kazuhito; Ikegami, Toru; Itoh, Shinji; Harada, Noboru; Motomura, Takashi; Toshima, Takeo; Mano, Yohei; Soejima, Yuji; Maehara, Yoshihiko.

In: Transplantation, Vol. 102, No. 9, 01.09.2018, p. e382-e391.

Research output: Contribution to journalArticle

Imai, Daisuke ; Yoshizumi, Tomoharu ; Sakata, Kazuhito ; Ikegami, Toru ; Itoh, Shinji ; Harada, Noboru ; Motomura, Takashi ; Toshima, Takeo ; Mano, Yohei ; Soejima, Yuji ; Maehara, Yoshihiko. / Long-term Outcomes and Risk Factors after Adult Living Donor Liver Transplantation. In: Transplantation. 2018 ; Vol. 102, No. 9. pp. e382-e391.
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abstract = "Background Although risk factors for the long-term mortality of liver transplantation are well described, there is a lack of detailed study regarding these factors for adult living donor liver transplantation (LDLT). Methods We retrospectively analyzed 528 adult LDLT recipients in our hospital. The risk factors were analyzed for overall deaths more than 5 years post-LDLT. Results Over the 20-year follow-up, 137 patients died. Patient survival at 1, 3, 5, and 10 years post-LDLT was 87.8{\%}, 81.8{\%}, 79.4{\%}, and 72.8{\%}, respectively. The independent risk factors for more than 5 years post-LDLT overall death were hepatocellular carcinoma recurrence (hazard ratio [HR], 38.9; P < 0.001), lymphoid de novo malignancy (HR, 47.2; P = 0.001), primary sclerosing cholangitis as primary diagnosis (HR, 11.5; P < 0.001), chronic rejection (HR, 6.93; P = 0.006), acute rejection (HR, 2.96; P = 0.017), and bile duct stenosis (HR, 2.30; P = 0.045). Conclusions Not only malignancies and rejection but also bile duct stenosis and primary sclerosing cholangitis had significant impacts on late period post-LDLT mortality.",
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AU - Itoh, Shinji

AU - Harada, Noboru

AU - Motomura, Takashi

AU - Toshima, Takeo

AU - Mano, Yohei

AU - Soejima, Yuji

AU - Maehara, Yoshihiko

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N2 - Background Although risk factors for the long-term mortality of liver transplantation are well described, there is a lack of detailed study regarding these factors for adult living donor liver transplantation (LDLT). Methods We retrospectively analyzed 528 adult LDLT recipients in our hospital. The risk factors were analyzed for overall deaths more than 5 years post-LDLT. Results Over the 20-year follow-up, 137 patients died. Patient survival at 1, 3, 5, and 10 years post-LDLT was 87.8%, 81.8%, 79.4%, and 72.8%, respectively. The independent risk factors for more than 5 years post-LDLT overall death were hepatocellular carcinoma recurrence (hazard ratio [HR], 38.9; P < 0.001), lymphoid de novo malignancy (HR, 47.2; P = 0.001), primary sclerosing cholangitis as primary diagnosis (HR, 11.5; P < 0.001), chronic rejection (HR, 6.93; P = 0.006), acute rejection (HR, 2.96; P = 0.017), and bile duct stenosis (HR, 2.30; P = 0.045). Conclusions Not only malignancies and rejection but also bile duct stenosis and primary sclerosing cholangitis had significant impacts on late period post-LDLT mortality.

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