Analysis of survival after liver transplantation in Galicia, Spain.
BACKGROUND
Transplantation is the treatment of choice for many patients with end-stage liver disease. We evaluated the results of liver transplantation in Galicia, an autonomous community in Northwest Spain.


METHODS
We analyzed 452 patients and 490 grafts from 1996 to 2000 for causes of loss with respect to recipient and donor variables using the actuarial method, Kaplan-Meier curves, log-rank test, and Cox proportional risks model.


RESULTS
The overall graft survival was 77% and 64% at 1 and 5 years, respectively; while that of the patients was 83% and 69%. The risk factors for graft loss were donation in heart failure (HR = 4.91, CI:2.51-9.61); donor age (HR = 1.70, CI:1.01-2.85 between 40 and 60 years; HR = 2.37, CI:1.37-4.10 in those over 60 years, as compared to patients under 40); urgent transplant (HR = 3.95, CI:2.07-7.54); and transplant due to acute liver failure (HR = 3.53, CI:1.72-7.25) as compared to alcoholic cirrhosis. For patient death the risk factors were age of recipient over 60 years, compared to those under 40 (HR = 2.42, CI:1.11-5.28); foreign place of origin (HR = 2.02, CI:1.14-3.59); transplant due to viral cirrhosis (HR = 1.76, CI:1.03-3.02) and transplant due to acute liver failure (HR = 4.62, CI:2.12-10.06), as compared to alcoholic cirrhosis; urgent transplant (HR = 2.65, CI:1.48-4.72), and age of donor over 60 years, as compared to those under 40 (HR = 2.65, CI:1.48-4.72). Infections were the principal cause of death (45%), mostly in the first month (72%); while after the first year, 74% were due to recurrence of the primary disease and de novo malignancy.


CONCLUSIONS
Graft and patient survivals were comparable to international registries. The donor characteristics had a greater influence on graft survival than on patient survival.
Otero-Raviña
F
F
Health Care Coordination Section, Servicio Galego de Saúde, Santiago de Compostela, Spain. ravino@terra.es
Rodríguez-Martínez
M
M
Sellés
C Fernández
CF
Gutiérrez
M Gómez
MG
Blanco
M Delgado
MD
de Rituerto
S Tomé Martínez
ST
Pérez
E Varo
EV
González-Juanatey
J R
JR
Sánchez-Guisande Jack
D
D
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006333:Heart Failure / Q000150:complications; D006801:Humans; D007223:Infant; D007239:Infections / Q000401:mortality; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D015996:Survival Rate; D014019:Tissue Donors / Q000706:statistics & numerical data