title: Living vs. deceased donor liver transplantation provides comparable recovery of renal function in patients with hepatorenal syndrome: a matched case-control study.
abstract: Outcomes of living versus deceased donor liver transplantation in patients with chronic liver disease and hepatorenal syndrome (HRS) was compared using a matched pair study design. Thirty patients with HRS receiving a live donor liver transplantation (LDLT) and 90 HRS patients receiving a full graft deceased donor liver transplantation (DDLT) were compared. LDLT versus DDLT of patients with HRS was associated with decreased peak aspartate aminotransferase levels (339 ± 214 vs. 935 ± 1253 U/L; p = 0.0001), and similar 7-day bilirubin (8.42 ± 7.89 vs. 6.95 ± 7.13 mg/dL; p = 0.35), and international normalized ratio levels (1.93 ± 0.62 vs. 1.78 ± 0.78; p = 0.314). LDLT vs. DDLT had a decreased intensive care unit (2 [1-39] vs. 4 [0-93] days; p = 0.004), and hospital stay (17 [4-313] vs. 26 [0-126] days; p = 0.016) and a similar incidence of overall postoperative complications (20% vs. 27%; p = 0.62). No difference was detected between LDLT and DDLT patients regarding graft survival at 1 (80% vs. 82%), at 3 (69% vs. 76%) and 5 years (65% vs. 76%) (p = 0.63), as well as patient survival at 1 (83% vs. 82%), 3 (72% vs. 77%) and 5 years (72% vs. 77%) (p = 0.93). The incidence of chronic kidney disease post-LT (10% vs. 6%; p = 0.4) was similar between both groups. LDLT results in identical long-term outcome when compared with DDLT in patients with HRS.
authors.affiliation: Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Goldaracena
authors.forename: M
authors.initials: M
authors.lastname: Marquez
authors.forename: N
authors.initials: N
authors.lastname: Selzner
authors.forename: V N
authors.initials: VN
authors.lastname: Spetzler
authors.forename: M S
authors.initials: MS
authors.lastname: Cattral
authors.forename: P D
authors.initials: PD
authors.lastname: Greig
authors.forename: L
authors.initials: L
authors.lastname: Lilly
authors.forename: I D
authors.initials: ID
authors.lastname: McGilvray
authors.forename: G A
authors.initials: GA
authors.lastname: Levy
authors.forename: A
authors.initials: A
authors.lastname: Ghanekar
authors.forename: E L
authors.initials: EL
authors.lastname: Renner
authors.forename: D R
authors.initials: DR
authors.lastname: Grant
authors.forename: M
authors.initials: M
authors.lastname: Selzner
mesh_terms: D000328:Adult; D002102:Cadaver; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000453:epidemiology* / Q000401:mortality; D006085:Graft Survival; D006530:Hepatorenal Syndrome / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000401:mortality; D007677:Kidney Function Tests; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: Clinical research/practice; hepatorenal syndrome; kidney transplantation/nephrology; liver disease; liver transplantation/hepatology; liver transplantation: living donor