title: Association of preoperative parameters with postoperative mortality and long-term survival after liver transplantation.
abstract: BACKGROUND
  The ability of Child-Turcotte-Pugh (CTP) or Model for End-Stage Liver Disease (MELD) scores to predict recipient survival after liver transplantation is controversial. This analysis aims to identify preoperative parameters that might be associated with early postoperative mortality and long-term survival after liver transplantation.
  
  
  METHODS
  We studied a total of 15 parameters, using both univariate and multivariate models, among adults who underwent primary liver transplantation.
  
  
  RESULTS
  A total of 458 primary adult liver transplants were performed. Fifty-seven (12.44%) patients died during the first 3 postoperative months and composed the early mortality group. The remaining 401 patients composed the long-term patient survival group. The parameters that were identified through univariate analysis to be associated with early postoperative mortality were CTP score, MELD score, bilirubin, creatinine, international normalized ratio and warm ischemia time (WIT). In all multivariate models, WIT retained its statistical significance. The 10-year long-term survival was 65%. The parameters that were identified to be independent predictors of long-term survival were the recipient's sex (improved survival in women, p = 0.005), diagnosis of hepatocellular cancer (p=0.015) and recipient's age (p=0.024).
  
  
  CONCLUSIONS
  Either CTP or MELD score, in conjunction with WIT, might have a role in predicting early postoperative mortality after liver transplantation, whereas the recipient's sex and the absence of hepatocellular cancer are associated with improved long-term survival.
authors: Department of Surgery and the Multi-Organ Transplant Program, McGill University, Montréal, Que., Canada. vrochides@yahoo.com
authors: Dionisios
authors: D
authors: Vrochides
authors: Mazzen
authors: M
authors: Hassanain
authors: Jeffrey
authors: J
authors: Barkun
authors: Jean
authors: J
authors: Tchervenkov
authors: Steven
authors: S
authors: Paraskevas
authors: Prosanto
authors: P
authors: Chaudhury
authors: Marcelo
authors: M
authors: Cantarovich
authors: Marc
authors: M
authors: Deschenes
authors: Phil
authors: P
authors: Wong
authors: Peter
authors: P
authors: Ghali
authors: Gabriel
authors: G
authors: Chan
authors: Peter
authors: P
authors: Metrakos
mesh_terms: D000328:Adult; D058625:End Stage Liver Disease / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D015999:Multivariate Analysis; D057234:Preoperative Period; D011379:Prognosis; D012720:Severity of Illness Index