Postoperative hyperbilirubinemia and graft outcome in living donor liver transplantation.

Little information is available on the characteristics and clinical significance of serum bilirubin level early after liver transplantation. The aim of this study was to clarify the risk factors for early graft loss and to assess the significance of postoperative hyperbilirubinemia as a predictor of graft outcome in living donor liver transplantation (LDLT). We retrospectively analyzed perioperative parameters in 68 patients who underwent LDLT. Graft loss within 1 year post-LDLT was confirmed in 9 patients (13.4%). Univariate analysis of risk factors showed that preoperative Model for End-Stage Liver Disease score, donor age, postoperative peak serum bilirubin level (p-BIL) within 28 days after LDLT, and surgical complications were significant determinants of early graft loss (<1 year post-transplant). Multivariate analysis identified p-BIL (odds ratio = 1.170, 95% confidence interval = 1.030-1.329, P = 0.016) as the only independent predictor of early graft loss. The incidence of such loss was high in patients with p-BIL over 27.0 mg/dL (area under the receiver operating characteristic curve = 0.988). In conclusion, serum bilirubin level is a useful predictor of short-term (<1 year) graft outcome and for considering retransplantation in a timely fashion.

Marubashi S ，Dono K ，Nagano H ，Asaoka T ，Hama N ，Kobayashi S ，Miyamoto A ，Takeda Y ，Umeshita K ，Monden M ... -  《LIVER TRANSPLANTATION》

Factors affecting postoperative hyperbilirubinemia in the donor after living donor liver transplantation.

Kamo N ，Kaido T ，Mori A ，Hatano E ，Takada Y ，Egawa H ，Uemoto S ... -  《hepato-gastroenterology》

Impact of preoperative serum sodium concentration in living donor liver transplantation.

Fukuhara T ，Ikegami T ，Morita K ，Umeda K ，Ueda S ，Nagata S ，Sugimachi K ，Gion T ，Yoshizumi T ，Soejima Y ，Taketomi A ，Maehara Y ... -  《-》

Early postoperative renal dysfunction in the adult living donor liver transplantation.

Lee SK ，Park JB ，Kim SJ ，Choi GS ，Kim DJ ，Kwon CH ，Lee SK ，Joh JW ... -  《TRANSPLANTATION PROCEEDINGS》

Which score system can best predict recipient outcomes after living donor liver transplantation?

Many scoring systems have been suggested to predict the outcomes of deceased donor liver transplantations. The aims of this study were to compare the Model for End-Stage Liver Disease (MELD) score with respect to other scores among patients who underwent living donor liver transplantation (LDLT) seeking to evaluate the best system to correlate with postoperative outcomes after LDLT. We analyzed retrospectively data from 202 adult patients who underwent LDLT from January 2008 to July 2010. We calculated preoperative MELD, MELD-sodium, MELD to serum sodium ratio (MESO), integrated MELD, United Kingdom MELD, Child-Turcotte-Pugh, Acute Physiology and Chronic Health evaluation II (APACHE II), and Sequential Organ Failure Assessment (SOFA) scores in all patients. We analyzed the correlation of each score with postoperative laboratory results, as well as survival at 1, 3, 6 and 12 months after LDLT. There was significant positive correlation between all scores and peak total bilirubin during the first 7 days after LDLT. The MELD score showed the greatest correlation with peak total bilirubin (r=0.745). APACHE II and SOFA scores at 6 months and 1 year after LDLT and MESO score at 1 year after LDLT showed acceptable discrimination performance {area under the receiver operating characteristic curves (AUC)>0.7, while other scoring systems showed poor discrimination. However, the AUCs of each score were not significantly different from the MELD score AUC. The MELD score most correlated with total bilirubin after LDLT, while the APACHE II and SOFA scores seemed to correlate with mortality after LDLT.

Chung IS ，Park M ，Ko JS ，Gwak MS ，Kim GS ，Lee SK ... -  《-》