Living vs. deceased donor liver transplantation provides comparable recovery of renal function in patients with hepatorenal syndrome: a matched case-control study.

Goldaracena, N; Marquez, M; Selzner, N; Spetzler, V N; Cattral, M S; Greig, P D; Lilly, L; McGilvray, I D; Levy, G A; Ghanekar, A; Renner, E L; Grant, D R; Selzner, M

Goldaracena, N; Marquez, M; Selzner, N; Spetzler, V N; Cattral, M S; Greig, P D; Lilly, L; McGilvray, I D; Levy, G A; Ghanekar, A; Renner, E L; Grant, D R; Selzner, M.

Afiliación

Goldaracena N; Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, Ontario, Canada.

Am J Transplant ; 14(12): 2788-95, 2014 Dec.

Article en En | MEDLINE | ID: mdl-25277134

RESUMEN

Outcomes of living versus deceased donor liver transplantation in patients with chronic liver disease and hepatorenal syndrome (HRS) was compared using a matched pair study design. Thirty patients with HRS receiving a live donor liver transplantation (LDLT) and 90 HRS patients receiving a full graft deceased donor liver transplantation (DDLT) were compared. LDLT versus DDLT of patients with HRS was associated with decreased peak aspartate aminotransferase levels (339 ± 214 vs. 935 ± 1253 U/L; p = 0.0001), and similar 7-day bilirubin (8.42 ± 7.89 vs. 6.95 ± 7.13 mg/dL; p = 0.35), and international normalized ratio levels (1.93 ± 0.62 vs. 1.78 ± 0.78; p = 0.314). LDLT vs. DDLT had a decreased intensive care unit (2 [1-39] vs. 4 [0-93] days; p = 0.004), and hospital stay (17 [4-313] vs. 26 [0-126] days; p = 0.016) and a similar incidence of overall postoperative complications (20% vs. 27%; p = 0.62). No difference was detected between LDLT and DDLT patients regarding graft survival at 1 (80% vs. 82%), at 3 (69% vs. 76%) and 5 years (65% vs. 76%) (p = 0.63), as well as patient survival at 1 (83% vs. 82%), 3 (72% vs. 77%) and 5 years (72% vs. 77%) (p = 0.93). The incidence of chronic kidney disease post-LT (10% vs. 6%; p = 0.4) was similar between both groups. LDLT results in identical long-term outcome when compared with DDLT in patients with HRS.

Asunto(s)

Rechazo de Injerto/epidemiología; Síndrome Hepatorrenal/cirugía; Fallo Renal Crónico/epidemiología; Trasplante de Hígado; Donadores Vivos; Complicaciones Posoperatorias; Adulto; Cadáver; Estudios de Casos y Controles; Femenino; Estudios de Seguimiento; Tasa de Filtración Glomerular; Rechazo de Injerto/mortalidad; Supervivencia de Injerto; Humanos; Incidencia; Fallo Renal Crónico/mortalidad; Pruebas de Función Renal; Masculino; Persona de Mediana Edad; Pronóstico; Estudios Prospectivos; Factores de Riesgo; Tasa de Supervivencia

Palabras clave

Clinical research/practice; hepatorenal syndrome; kidney transplantation/nephrology; liver disease; liver transplantation/hepatology; liver transplantation: living donor

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Síndrome Hepatorrenal / Trasplante de Hígado / Donadores Vivos / Rechazo de Injerto / Fallo Renal Crónico Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2014 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos

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