Adult living donor liver transplantation: body mass index and MELD score of recipients are independent risk factors for hospital mortality

• Published in: Langenbeck's archives of surgery Vol. 394; no. 2; pp. 235 - 241
• Main Authors: Tsui, Tung-Yu, Scherer, Marcus N., Schnitzbauer, Andreas A., Schlitt, Hans J., Obed, Aiman
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-03-2009
• Subjects: Abdominal Surgery; Adolescent; Adult; Body Mass Index; Cardiac Surgery; Cause of Death; Cohort Studies; Female; Follow-Up Studies; General Surgery; Germany; Hepatectomy - methods; Hospital Mortality; Humans; Jordan; Length of Stay - statistics & numerical data; Liver Failure - classification; Liver Failure - surgery; Liver Function Tests; Liver Transplantation - mortality; Living Donors - statistics & numerical data; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Postoperative Complications - mortality; Prognosis; Renal Insufficiency - complications; Renal Insufficiency - mortality; Risk Factors; Thoracic Surgery; Tissue and Organ Harvesting - methods; Traumatic Surgery; Vascular Surgery; Young Adult; Jordan; Germany; Body mass index; Hospital mortality; MELD score; Adults; Living donor liver transplantation
• DOI: 10.1007/s00423-008-0348-9
• EISSN: 1435-2451
• ISSN: 1435-2443

Background and aims
Adult living donor liver transplantation (LDLT) has been established as elective procedure or urgent procedure to save the life of patients with terminal liver diseases. The outcome of LDLT varies between transplant centers. Here, we aim to evaluate the outcome of LDLT in our center and to identify the risk factors that are associated with hospital mortality of recipients.
Patients and methods
A cohort study with 32 consecutive cases of adult living donor liver transplantation was conducted in two cooperated medical centers. Perioperative data, incidence of postoperative complications, and hospital mortality were analyzed.
Results
No major surgical complications and no hospital mortality were observed in all 32 donors. All donors were discharged with normal liver function with median intensive care unit (ICU) stay of 1 day and median hospital stay of 10 days. All recipients had normal liver function in early posttransplant period. Eighty-one percent of the recipient survived with normal liver function for more than 1 year. The pretransplant ICU stay, renal failure, international normalized ratio (>1.8), and Model for End-stage Liver Disease (MELD) score (>20) were independent risk factors for hospital mortality of recipients.
Conclusions
Adult living donor liver transplantation should be reserved to less “sick” patients in the era of organ allocation based on MELD score.