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. 2019 May 3:24:242-251.
doi: 10.12659/AOT.914246.

Risk Factors for High Mortality on the Liver Transplant Waiting List in Times of Organ Shortage: A Single-Center Analysis

Peri Husen  1 , Julian Hornung  1 , Tamas Benko  1 , Christian Klein  1 , Katharina Willuweit  2 , Matthias Buechter  2 , Fuat Hakan Saner  1 , Andreas Paul  1 , Juergen Walter Treckmann  1 , Dieter Paul Hoyer  1
Affiliations

Risk Factors for High Mortality on the Liver Transplant Waiting List in Times of Organ Shortage: A Single-Center Analysis

Peri Husen et al. Ann Transplant. .

Abstract

BACKGROUND Germany has the highest rate of patients dying or becoming unfit for transplant while waitlisted within the Eurotransplant region. Therefore, the aim of the current study was to analyze mortality as well as risk factors for mortality of candidates listed for liver transplantation at our center. MATERIAL AND METHODS Between 01/2011 and 12/2013, 481 adult patients were listed for primary liver transplantation (LT) at a single German center. Clinical and laboratory parameters were prospectively collected and retrospectively analyzed by univariable and multivariable logistic regression and Cox proportional hazards. RESULTS The mean model for end-stage liver disease (MELD) score of all liver transplant waitlist registrants (52.4 years, 60.1% male) was 16.9 (±10.2) at time of listing, with 10% of the listed patients having a MELD score of >32. After waitlisting, 133 (27.7%) candidates died within the follow-up period. Three-month-survival after listing for transplantation was 89% for patients ultimately receiving LT vs. 71.2% that did not receive LT (p<0.001). Multivariable analysis identified clinical parameters such as ICU treatment, preceding abdominal surgery, variceal bleeding, and ascites, as well as hydropic decompensation, as independent risk factors for waitlist mortality. CONCLUSIONS Consideration of independent risk factors of mortality within the MELD-based allocation system potentially improves assessment of individual urgency and might improve utilization of available organs.

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Conflict of interest statement

Conflicts of interest

None.

Figures

Figure 1
Figure 1
Survival after listing for liver transplantation for patients undergoing liver transplantation (LT) and not undergoing liver transplantation (no LT). LT – liver transplantation.
See this image and copyright information in PMC

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