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Recipient morbidity after living and deceased donor liver transplantation: findings from the A2ALL Retrospective Cohort Study.
Freise, C E; Gillespie, B W; Koffron, A J; Lok, A S F; Pruett, T L; Emond, J C; Fair, J H; Fisher, R A; Olthoff, K M; Trotter, J F; Ghobrial, R M; Everhart, J E.
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  • Freise CE; Department of Surgery, University of California San Francisco, San Francisco, CA, USA. freisec@surgery.ucsf.edu
Am J Transplant ; 8(12): 2569-79, 2008 Dec.
Article en En | MEDLINE | ID: mdl-18976306
Patients considering living donor liver transplantation (LDLT) need to know the risk and severity of complications compared to deceased donor liver transplantation (DDLT). One aim of the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) was to examine recipient complications following these procedures. Medical records of DDLT or LDLT recipients who had a living donor evaluated at the nine A2ALL centers between 1998 and 2003 were reviewed. Among 384 LDLT and 216 DDLT, at least one complication occurred after 82.8% of LDLT and 78.2% of DDLT (p = 0.17). There was a median of two complications after DDLT and three after LDLT. Complications that occurred at a higher rate (p < 0.05) after LDLT included biliary leak (31.8% vs. 10.2%), unplanned reexploration (26.2% vs. 17.1%), hepatic artery thrombosis (6.5% vs. 2.3%) and portal vein thrombosis (2.9% vs. 0.0%). There were more complications leading to retransplantation or death (Clavien grade 4) after LDLT versus DDLT (15.9% vs. 9.3%, p = 0.023). Many complications occurred more commonly during early center experience; the odds of grade 4 complications were more than two-fold higher when centers had performed 40). In summary, complication rates were higher after LDLT versus DDLT, but declined with center experience to levels comparable to DDLT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Donantes de Tejidos / Trasplante / Trasplante de Hígado / Donadores Vivos Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2008 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Donantes de Tejidos / Trasplante / Trasplante de Hígado / Donadores Vivos Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2008 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos