[Clinical factors influencing the complications and survival of liver transplantation in Hungary].
Clinical factors in association with the complications and the outcome of liver transplantation. The Hungarian experience. Demography, morbidity, perioperative characteristics and mortality.


BACKGROUND
The authors summarize the demographic, morbidity and mortality characteristics of the Hungarian Liver Transplant Program. They evaluate the changes and development, that has taken place with regard to indications, recipient population and characteristics, operation technique, and peroperative patient management.


METHODS
In order to present the development, data are compared between two time periods (before and after 1999). Categorical variables are evaluated by chi-square test, continuous ones are with Levene Test (for homogeneity of means), Student T test and Mann-Whitney U-test. Cumulative survivals are computed with Kaplan-Meyer log rank analysis. Variables showed statistical significance on survival bz univariate analysis were then put into multivariate Cox-regression analysis. ROC analysis was performed to set the cut off point of certain continuous parameters in relation to survival.


RESULTS
The results are summarized on Tables and statistical Figures. Regarding patients mortality in the beginning the main factors with impact were respectively technical ones like arterial thrombosis, while in the last 4 years perioperative fluid management and transfusion policy became important. Both sepsis and postoperative renal insufficiency remained key factors for mortality, however their incidence diminished dramatically.


CONCLUSIONS
The overall outcome of the retrospective analysis is, that the program has been developed to European standards with respect to its volume, technical capabilities and results.
Nemes
Balázs
B
Semmelweis Egyetem, Altalános Orvostudomanyi Kar, Transzplantációs es Sebészeti Klinika, Budapest. nemes@trans.sote.hu
Kóbori
László
L
Gálffy
Zsuzsa
Z
Lengyel
Gabriella
G
Doros
Attila
A
Sárváry
Enikó
E
Perner
Ferenc
F
Schaff
Zsuzsa
Z
Fazakas
János
J
Szalay
Ferenc
F
Féher
János
J
Járay
Jeno
J
D000704:Analysis of Variance; D001660:Biliary Tract Diseases / Q000209:etiology; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006499:Hepatic Artery; D006530:Hepatorenal Syndrome / Q000150:complications; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D008297:Male; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D016016:Proportional Hazards Models; D012372:ROC Curve; D051437:Renal Insufficiency / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D013927:Thrombosis / Q000209:etiology; D016896:Treatment Outcome
D007166:Immunosuppressive Agents