RISS 검색 - 국내학술지논문 상세보기

부가정보

다국어 초록 (Multilingual Abstract)

Aims: Mortality after liver transplantation (LT) depends on many factors. Our aim was to assess short-term outcomes after first LT in a cohort of adult recipients form the national wide database in Korea and identify predictors of in-hospital mortality that could avoid futile LT.
Methods: We analyzed data from Health Insurance Review and Assessment Service (HIRA) which is a government-affiliated organization that reviews claim accuracy and assess the quality for the National Health Insurance (NHI) between Aug, 2009 and July, 2014. The patients who had procedural codes of the Korea NHI concerning LT (Q8040-Q8050, Q8140-Q8150) were categorized as patients who received LT. We analyzed the effect of several risk factors on survival by multivariable logistic models.
Results: Total 5375 patients had first liver transplantation in this period (1433 received from deceased donor (DD) and 3942 received form living donor (LD)). Mean age was 52.3±8.9 years old and 72.8% (n = 3913) was male. Most common underlying cause of LT was viral hepatitis (46.9 %) due to hepatitis B or C virus, with or without malignant neoplasm of liver. Total 346 patients (6.4%) were died after liver transplantation before hospital discharge. DDLT recipients’ mortality was 14.0% (n = 200) and LDLT recipients’ mortality was 3.7% (n = 146) (p < 0.001). Multiple logistic analysis identified four variables associated with patient survival: recipient age older than 65 years old, recipient on mechanical ventilation more than 3 days, recipients on perioperative hemodialysis, and vasopressor support more than 2 days.
Conclusions: Our data shows recipient age, mechanical ventilation, dialysis, and shock had an ability to predict short term outcome. Our results can be used to identify futile cases in which expected outcomes is too poor to justify transplantation.