Living-related liver transplantation in patients with variceal bleeding: outcome and prognostic factors.
BACKGROUND
Liver transplantation currently represents the ultimate therapy for bleeding esophageal varices in patients with liver cirrhosis. It is the only therapy that cures both portal hypertension and the underlying liver disease. The outcome of liver transplantation is thought to be correlated with several factors. In this study, the clinical outcome of living-related liver transplantation (LRLT) was evaluated in patients with variceal bleeding, and the prognostic indicators of short-term survival in these patients were identified.


METHODS
We reviewed retrospectively 121 patients with a history of variceal bleeding who had received LRLT from 1998 to 2006. The clinical outcomes were analyzed, and the risk factors for short-term survival were defined.


RESULTS
The 3-month survival rate of patients with variceal bleeding was 83.4%, while that of non-bleeders was 87%. Sepsis was the commonest cause of death in both groups. Portal vein diameter and blood transfusion were the only independent prognostic factors for short-term survival among variceal bleeders.


CONCLUSIONS
The outcome of LRLT in recipients with variceal bleeding is based on the improvement of portal hemodynamics, by minimizing intraoperative blood loss and subsequent blood transfusion.
Hedaya
Mohammed Saied
MS
Department of Hepato-Biliary-Pancreatic and Transplant Surgery, Kyoto University, Japan. hedayamsm@yahoo.com
El Moghazy
Walid Mohamed
WM
Uemoto
Shinji
S
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000503:physiopathology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D065227:Transfusion Reaction; D016896:Treatment Outcome