American Society of Transplant Surgeons. Annual meeting. Chicago IL USA, 1995/05/17.
Liver transplantation for patients requiring life-support results in the lowest survival and highest costs.
A ten year (1983-1993) regional experience with liver transplantation for critically ill patients was undertaken to ascertain the fate of several subgroups of patients.
Of the 828 liver transplants performed at six transplant centers within the region over this period, 168 (20%) were done in patients who met today's criteria for a United Network of Organ Sharing (UNOS) status 1 (emergency) liver transplant candidate.
Recipients were classified according to chronicity of disease and transplant number (primary-acute, primary-chronic, reTx-acute, reTx-chronic).
Overall one-year survival was 50% for all status 1 recipients.
The primary-acute subgroup (n=63) experienced a 57% one-year survival compared with 50% for the primary-chronic (n=51) subgroup (P=0.07).
Of the reTx-acute recipients (n=43), 44% were alive at one year in comparison with 20% for the reTx-chronic (n=11) group (P=0.18).
There was no significant difference in survival for the following : transplant center, blood group compatibility with donors, age, preservation solution, or graft size.
For patients retransplanted for acute reasons (primary graft nonfunction (PGNF) or hepatic artery thrombosis [HAT]), survival was significantly better if a second donor was found within 3 days of relisting (52% vs. 20% ; P=0.012).
Over the study period progressively fewer donor organs came from outside th...
Mots-clés Pascal : Homotransplantation, Foie, Urgence, Etude multicentrique, Pronostic, Réintervention, Facteur risque, Priorité, Critère sélection, Courbe survie, Etats Unis, Amérique du Nord, Amérique, Transplantation, Chirurgie, Foie pathologie, Appareil digestif pathologie
Mots-clés Pascal anglais : Homotransplantation, Liver, Emergency, Multicenter study, Prognosis, Reoperation, Risk factor, Priority, Selection criterion, Survival curve, United States, North America, America, Transplantation, Surgery, Hepatic disease, Digestive diseases
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Code Inist : 002B25G03. Création : 199608.