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. 2021 Jul;27(3):451-462.
doi: 10.3350/cmh.2020.0292. Epub 2021 Feb 2.

Outcomes after liver transplantation in Korea: Incidence and risk factors from Korean transplantation registry

Jong Man Kim  1 , Deok Gie Kim  2 , Jihyun Kim  3 , Keunsung Lee  3 , Kwang-Woong Lee  4 , Je Ho Ryu  5 , Bong-Wan Kim  6 , Dong Lak Choi  7 , Young Kyoung You  8 , Dong-Sik Kim  9 , Yang Won Nah  10 , Koo Jeong Kang  11 , Jai Young Cho  12 , Geun Hong  12 , Hee Chul Yu  13 , Ju Ik Moon  14 , Dongho Choi  15 , Shin Hwang  16 , Myoung Soo Kim  17
Affiliations

Outcomes after liver transplantation in Korea: Incidence and risk factors from Korean transplantation registry

Jong Man Kim et al. Clin Mol Hepatol. 2021 Jul.

Abstract

Background/aims: To analyze the incidence and risk factors of outcomes after liver transplantation (LT) in the Korean population.

Methods: This study analyzed data from the liver cohort of Korean Organ Transplantation Registry (KOTRY) who had LT between May 2014 and December 2017. Study measures included the incidence of post-LT outcomes in recipients of living donor LT (LDLT) and deceased donor LT (DDLT). Cox multivariate proportional hazards model was used to determine the potential risk factors predicting the outcomes.

Results: A total of 2,563 adult recipients with LT (LDLT, n=1,956; DDLT, n=607) were included, with mean±standard deviation age of 53.9±8.9 years, and 72.2% were male. The post-LT outcomes observed in each LDLT and DDLT recipients were death (4.0% and 14.7%), graft loss (5.0% and 16.1%), rejection (7.0% and 12.0%), renal failure (2.7% and 13.8%), new onset of diabetes (12.5% and 15.4%), and hepatocellular carcinoma (HCC) recurrence (both 6.7%). In both LDLT and DDLT recipients, the most common post-LT complications were renal dysfunction (33.6% and 51.4%), infection (26.7% and 48.4%), and surgical complication (22.5% and 23.9%). Incidence of these outcomes were generally higher among recipients of DDLT than LDLT. Multivariate analysis indicated recipient age and DDLT as significant risk factors associated with death and graft loss. DDLT and ABO incompatible transplant were prognostic factors for rejection, and HCC beyond Milan criteria at pre-transplant was a strong predictor of HCC recurrence.

Conclusion: This study is a good indicator of the post-LT prognosis in the Korean population and suggests a significant burden of post-LT complications.

Keywords: Incidence; Liver transplantation; Renal insufficiency; Risk factors.

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Conflict of interest statement

Conflicts of Interest

JM Kim, DG Kim and MS Kim received grants from Novartis Korea Ltd., South Korea for the conduct of this study. KS Lee employees of Novartis Korea Ltd., South Korea. JH Kim was an employee of Novartis Korea Ltd., South Korea at the time of conduct of this study, and left. Authors declare that they have no other conflicts of interest regarding the content of this manuscript.

Figures

Figure 1.
Figure 1.
The incidence of post-transplantation outcomes among the recipients of liver transplantation by type of donors. N is the total number of recipients in each group; n is the number of recipients with a particular outcome. In DDLT group, N=568 (for rejection) and N=254 (for HCC recurrence). In LDLT group, N=1,942 for rejection and N=1,245 for HCC recurrence. DDLT, deceased donor liver transplantation; LDLT, living donor liver transplantation; NODM, new onset of diabetes mellitus; HCC, hepatocellular carcinoma.
Figure 2.
Figure 2.
Causes of graft loss in adult patients with liver transplantation (N=195). N is the total number of recipients with graft loss; n is the number of recipients with a particular reason. HCC, hepatocellular carcinoma; IVC, inferior vena cava.
Figure 3.
Figure 3.
Kaplan-Meier survival curve of post-transplantation outcomes in adult patients with liver transplantation. LDLT, living donor liver transplantation; DDLT, deceased donor liver transplantation; HCC, hepatocellular carcinoma; NODM, new onset of diabetes mellitus.
None
See this image and copyright information in PMC

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