Liver and Intestine Transplantation in the United States, 1995–2004

Shiffman, Mitchell L.; Saab, Sammy; Feng, Sandy; Abécassis, Michaël; Tzakis, Andreas G.; Goodrich, Nathan P.; Schaubel, Douglas E.

doi:10.1111/j.1600-6143.2006.01273.x

Cited by 88 publications

(68 citation statements)

References 19 publications

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Section: See Editorial On Page 1404mentioning

confidence: 99%

“…1 Nevertheless, liver transplantation remains a major operative procedure carrying a perioperative mortality rate of around 8% and commonly gives rise to postoperative complications requiring further hospitalization. 1 Many patients requiring liver transplantation suffer a long period of progressive ill health prior to transplantation, and most are very unwell at the time of transplant. Full recovery from the transplant procedure and associated complications may take several months, and all liver transplant recipients require lifelong treatment with immunosuppressive agents and regular follow-up to detect and manage long-term health problems.…”

Section: See Editorial On Page 1404mentioning

confidence: 99%

“…Studies on short-term QOL following liver transplantation have reported gratifying results, and most but not all patients show an improvement in QOL compared to that prior to transplantation. [1][2][3][4] There is, however, little information on the longterm QOL in patients after liver transplantation. This report presents the findings of a single-center crosssectional study of QOL in patients more than 10 years after successful liver transplantation.…”

Section: See Editorial On Page 1404mentioning

confidence: 99%

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Quality of life up to 30 years following liver transplantation

et al. 2008

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Liver transplantation provides a return to a satisfactory quality of life (QOL) for the majority of patients in the short to medium term (first 5 years), but there is very little information on the QOL in the longer term and the factors influencing it. We therefore undertook a single-center cross-sectional analysis to determine QOL in patients 10 or more years after liver transplantation. All liver transplant recipients who were followed up at the Cambridge Transplant Unit for 10 or more years (transplanted between 1968 and 1994) and resident in the United Kingdom were asked to complete by post the Short Form 36 version 2 and the Ferrans and Powers questionnaires to evaluate their QOL. Univariate and multivariate analysis were performed to assess the relationship between a range of clinical parameters and QOL. One hundred two patients were invited to participate, and 61 (59.8%) responded. Overall, the patients reported a satisfactory QOL. On the Ferrans and Powers questionnaire, the patients had a mean Quality of Life Index score of 24.5. Factors associated with reduced physical functioning were age Ͼ 50 years at transplantation, female gender, and recurrence of the primary liver disease. On the Short Form 36 version 2 questionnaire, recipients had reduced physical functioning but normal mental health parameters in comparison with the normal population. Age Ͼ 60 years at the time of survey, female gender, and posttransplant complications were associated with reduced physical functioning. In conclusion, patients 10 or more years after liver transplantation generally have a good QOL, although physical functioning is reduced. Addressing issues such as recurrent disease and posttransplant problems such as osteoporosis may help to improve long-term QOL.

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Section: See Editorial On Page 1404mentioning

confidence: 99%

Section: See Editorial On Page 1404mentioning

confidence: 99%

Section: See Editorial On Page 1404mentioning

confidence: 99%

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Quality of life up to 30 years following liver transplantation

et al. 2008

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“…Since February 27, 2002, the Model for End-Stage Liver Disease (MELD) allocation system has shifted liver transplant allocation priority toward sicker patients, 15 while at the same time donor criteria have expanded in an attempt to keep up with the growing list of liver transplant candidates. In addition, overall indications for transplantation and immunosuppressive regimens have changed over time.…”

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confidence: 99%

Biliary complications following liver transplantation in the model for end-stage liver disease era: Effect of donor, recipient, and technical factors

et al. 2007

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Biliary complications remain a significant problem following liver transplantation in the Model for End-Stage Liver Disease (MELD) era. We hypothesized that donor, recipient, and technical variables may differentially affect anastomotic biliary complications in MELD era liver transplants. We reviewed 256 deceased donor liver transplants after the institution of MELD at our center and evaluated these variables' association with anastomotic biliary complications. The bile leak rate was 18%, and the stricture rate was 23%. Univariate analysis revealed that recipient age, MELD, donor age, and warm ischemia were risk factors for leak, whereas a Roux limb or stent was protective. A bile leak was a risk factor for anastomotic stricture, whereas use of histidine tryptophan ketoglutarate (HTK) versus University of Wisconsin (UW) solution was protective. Additionally, use of a transcystic tube/stent was also protective. Multivariate analysis showed that warm ischemia was the only independent risk factor for a leak, whereas development of a leak was the only independent risk factor for a stricture. HTK versus UW use and transcystic tube/stent use were the only independent protective factors against stricture. Use of an internal stent trended in the multivariate analysis toward being protective against leaks and strictures, but this was not quite statistically significant. This represents one of the first MELD era studies of deceased donor liver transplants evaluating factors affecting the incidence of anastomotic bile leaks and strictures. Donor, recipient, and technical factors appear to differentially affect the incidence of anastomotic biliary complications, with warm ischemia, use of HTK, and use of a stent emerging as the most important variables. Liver Transpl 14: 73-80, 2008.

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“…Chronic hepatitis C (CHC) is the major cause for liver transplantations in the USA (2). Currently, there is no approved, effective vaccine for HCV, and current treatments are expensive, unpleasant, and relatively ineffective.…”

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confidence: 99%