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Multicenter Study
. 2016 Feb;16(2):594-602.
doi: 10.1111/ajt.13479. Epub 2015 Oct 13.

Complications and Their Resolution in Recipients of Deceased and Living Donor Liver Transplants: Findings From the A2ALL Cohort Study

B Samstein  1 , A R Smith  2   3 , C E Freise  4 , M A Zimmerman  5 , T Baker  6 , K M Olthoff  7 , R A Fisher  8 , R M Merion  3   9
Affiliations
Multicenter Study

Complications and Their Resolution in Recipients of Deceased and Living Donor Liver Transplants: Findings From the A2ALL Cohort Study

B Samstein et al. Am J Transplant. 2016 Feb.

Abstract

The purpose of this study was to explore long-term complications in recipients of deceased donor liver transplant (DDLT) and living donor liver transplant (LDLT) in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). We analyzed 471 DDLTs and 565 LDLTs from 1998 to 2010 that were followed up to 10 years for 36 categories of complications. Probabilities of complications and their resolutions were estimated using the Kaplan-Meier method, and predictors were tested in Cox proportional hazards models. Median follow-up for DDLT and LDLT was 4.19 and 4.80 years, respectively. DDLT recipients were more likely to have hepatocellular carcinoma and higher disease severity, including Model for End-Stage Liver Disease score. Complications occurring with higher probability in LDLT included biliary-related complications and hepatic artery thrombosis. In DDLT, ascites, intra-abdominal bleeding, cardiac complications and pulmonary edema were significantly more probable. Development of chronic kidney disease stage 4 or 5 was less likely in LDLT recipients (hazard ratio [HR] 0.41, p = 0.02). DDLT and LDLT had similar risk of grade 4 complications (HR 0.89, p = 0.60), adjusted for other risk factors. Once a complication occurred, the time to resolution did not differ between LDLT and DDLT. Future efforts should be directed toward reducing the occurrence of complications after liver transplantation.

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Conflict of interest statement

Disclosures

The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.

Figures

Figure 1
Figure 1
Probability of Complications Significantly Different between LDLT and DDLT over all Follow-up
Figure 2
Figure 2
Figure 2a: Probability of Resolution of Selected Complications by Transplant Type Figure 2b: Probability of Resolution of Selected Complications by Transplant Type in the first 12 Months
Figure 2
Figure 2
Figure 2a: Probability of Resolution of Selected Complications by Transplant Type Figure 2b: Probability of Resolution of Selected Complications by Transplant Type in the first 12 Months
See this image and copyright information in PMC

References

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