Causes of mortality after liver transplantation: a single center experience in mainland china

Abstract

Background/aims: To analyze the causes of death, both in the short- and long-term after cadaveric liver transplantation (LT) from a single center in mainland China.

Methodology: Clinical data of 472 adult patients who underwent primary cadaveric LT from February 1999 to December 2009 at our center were identified. All patients were followed-up until December 2010. Mortalities in three periods were described: the postoperative mortality (within the first 90 postoperative days or more if the patient remained hospitalized); the early mortality (death between 4-12 months after transplantation); the late mortality (death after one year following transplantation).

Results: The survival of the 472 patients at 3 months, 1, 3 and 5 years was 85.2%, 73.5%, 61.2% and 59.7%, respectively. The postoperative mortality, the early mortality and the late mortality were 34.8% (70/201), 27.4% (55/201) and 37.8% (76/201), respectively. Infection, multi-organ failure and technical complications were the major causes of death during the first period, and the recurrence of malignancy was the main cause of death during the early and late periods after LT.

Conclusions: Recurrence of malignancy was the major cause of the early and late mortality in our study, which is higher than that of other reports. The serious preoperative condition of the recipient, the waiting timing for the operation and the tumor selection criteria for LT may account for this.