title: Early mortality in liver transplantation: bilirubin as predictor of outcome.
abstract: The shortage of donor organs and the long waiting lists have increased the need to better select liver transplant candidates using predictors of success. We reviewed the results of 29 liver transplantations performed from January 2002 to February 2003 analyzing the correlations with early mortality (30 days) of patient data, pretransplant laboratory data, warm ischemia time, intraoperations blood unit transfusions, and postoperative complications of prolonged mechanical ventilation, dialysis, and infection. Overall early mortality was 27.6% and 44% in fulminant hepatic failure (n = 9), there were four retransplants with one death, and two intraoperative deaths. Only pretransplant bilirubin (P =.045) and postoperative lactate levels (P =.002) were significantly different between alive versus dead patients. In this small population bilirubin was more related to death than the MELD score. Lactate levels, nonspecific predictor of death in shock syndromes were probably related to septic complications.
authors.affiliation: Liver Transplantation Unit, Hospital das Clínicas, Medical School, University of São Paulo, Sao Paulo, Brazil. de.medeiros@uol.com.br
authors.forename: D M
authors.initials: DM
authors.lastname: Medeiros
authors.forename: A C
authors.initials: AC
authors.lastname: Oliveira
authors.forename: M F A
authors.initials: MF
authors.lastname: Barros
authors.forename: R A
authors.initials: RA
authors.lastname: Cury
authors.forename: H
authors.initials: H
authors.lastname: Sette
authors.forename: E
authors.initials: E
authors.lastname: Abdala
authors.forename: L F
authors.initials: LF
authors.lastname: Canedo
authors.forename: F F
authors.initials: FF
authors.lastname: Makdissi
authors.forename: W
authors.initials: W
authors.lastname: Andraus
authors.forename: R B
authors.initials: RB
authors.lastname: Martino
authors.forename: V
authors.initials: V
authors.lastname: Rocha-Santos
authors.forename: E R R
authors.initials: ER
authors.lastname: Figueira
authors.forename: M A C
authors.initials: MA
authors.lastname: Machado
authors.forename: F J
authors.initials: FJ
authors.lastname: Carrilho
authors.forename: E L R
authors.initials: EL
authors.lastname: Cançado
authors.forename: T
authors.initials: T
authors.lastname: Bacchella
authors.forename: M C C
authors.initials: MC
authors.lastname: Machado
mesh_terms: D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D003710:Demography; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008107:Liver Diseases / Q000145:classification / Q000601:surgery; D017114:Liver Failure, Acute / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D015415:Biomarkers; D003404:Creatinine; D001663:Bilirubin