title: An Arterial Conduit is Not a Risk Factor for Survival Following Orthotopic Liver Transplantation: An Analysis of 20 Years of Liver Transplantation in Innsbruck.
abstract: BACKGROUND In adult liver transplantation, arterial conduits have been associated with increased risk for vascular complications and inferior outcome. MATERIAL AND METHODS Complication rates and outcomes of adult patients undergoing liver transplantation in our center between 1990 and 2012 were analyzed retrospectively. Characteristics, transplantation-related factors, and survival rates of patients with conduit grafts (n=43) were compared to patients with a standard arterial anastomosis (n=904) by univariate and multivariate analysis. RESULTS Patients in the conduit group were younger but had a significantly higher proportion of high-urgency and re-transplantations. While patient survival was comparable between the groups, graft survival was inferior for patients with a conduit (1-year, 5-year, and 10-year survival, control vs. conduit group: 87.3%, 78.8% and 71.5% vs. 72.4%, 63.8%, and 41.8%, respectively, p=0.008). In univariate analysis, an arterial conduit was associated with more arterial and biliary complications. However, an arterial conduit was not an independent risk factor for graft or patient survival in a Cox regression analysis. CONCLUSIONS An arterial conduit is associated with more vascular complications, yet a conduit per se does not influence graft survival. The inferior outcome may reflect the complex situation of the sicker liver transplant patients needing a non-standard arterial anastomosis.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charite Universitätsmedizin, Berlin, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Denecke
authors.affiliation: Department of General, Visceral, Vascular and Thoracic Surgery, Charite Universitätsmedizin, Berlin, Germany.
authors.forename: Sascha
authors.initials: S
authors.lastname: Weiss
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charite Universitätsmedizin, Berlin, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Biebl
authors.affiliation: Department of Medical Statistics, Informatics and Health Economics, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Josef
authors.initials: J
authors.lastname: Fritz
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Charite Universitätsmedizin, Berlin, Germany.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Dziodzio
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charite Universitätsmedizin, Berlin, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Aigner
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charite Universitätsmedizin, Berlin, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Sucher
authors.affiliation: Department of General, Visceral, Vascular and Thoracic Surgery, Charite Universitätsmedizin, Berlin, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Brandl
authors.affiliation: Department of Visceral, Transplantation and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Claudia
authors.initials: C
authors.lastname: Bösmüller
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Universitätsmedizin, Berlin, Berlin, Germany.
authors.forename: Johann
authors.initials: J
authors.lastname: Pratschke
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charite Universitätsmedizin, Berlin, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Öllinger
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000401:mortality*; D001317:Austria; D005260:Female; D006085:Graft Survival; D006499:Hepatic Artery / Q000601:surgery; D006801:Humans; D008099:Liver / Q000098:blood supply; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate