Long-Term Complications and Survival of Patients After Orthotopic Liver Transplantation

Muñoz, Linda; Nanez, Homero; Rositas, F.; Pérez, Ernesto; Razo, S.; Cordero, Paula; Torres, Lizeth; Zapata, Homero; Hernandez, Maria Antonia; Escobedo, M

doi:10.1016/j.transproceed.2010.05.007

Cited by 17 publications

(8 citation statements)

References 7 publications

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“…This is indicative of the severe preoperative morbidity and impairments associated with CLD. Complications such as late rejection leading to graft failure, recurrence of liver disease and de‐novo medical complications related to intensive immunosuppressive therapy become more common with increased survival . The frequency of surgical morbidity, both early and late, is likely to be a major contributor to suboptimal physical health compared to the general population.…”

Section: Discussionmentioning

confidence: 99%

Liver transplantation: a systematic review of long‐term quality of life

Yang

Shan

Saxena

et al. 2014

Liver International

168

136

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Background & Aims: Liver transplantation is the only curative intervention for terminal liver disease. Accurate long-term quality of life (QOL) data are required in the context of improved surgical outcomes and increasing posttransplant survival. This study reviews the long-term QOL after primary liver transplantation in adult patients surviving 5 or more years after surgery. Methods: A literature search was conducted on PubMed for all studies matching the eligibility criteria between January 2000 and October 2013. Bibliographies of included studies were also reviewed. Two authors independently performed screening of titles and abstracts. Consensus for studies included for review was achieved by discussion between authors based on predetermined eligibility criteria. Quality appraisal and data tabulation were performed using predetermined forms. Results were synthesized by narrative review. Results: Twenty-three studies (5402 patients) were included. QOL following liver transplantation remains superior to preoperative status up to 20 years post-operatively. More post-operative complications predicted worse QOL scores especially in physical domains. Benefits in functional domains persist long-term with independence in self-care and mobility. Employment rates recover in the short-term but decline after 5 years, and differ significantly between various aetiologies of liver disease. Overall QOL improves to a similar level as the general population, but physical function remains worse. Participation in post-operative physical activity is associated with superior QOL outcomes in liver transplant recipients compared to the general population. QOL improvements are similar compared to lung, kidney and heart transplantation. Heterogeneity between studies precluded quantitative analysis. Conclusions: Liver transplantation confers specific long-term QOL and functional benefits when compared to preoperative status. This information can assist in providing a more complete estimate of the overall health of liver transplant recipients and the effectiveness of surgery. Guidelines for future studies are provided.

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Section: Discussionmentioning

confidence: 99%

Liver transplantation: a systematic review of long‐term quality of life

Yang

Shan

Saxena

et al. 2014

Liver International

168

136

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“…Infections frequently affect transplant recipients [75], and although urinary infections and pyelonephritis are more frequent and severe in renal transplant recipients [76], surveillance, prompt diagnosis and therapy of possible infections is warranted in LT as well [21].…”

Section: Infectious Complicationsmentioning

confidence: 99%

AISF position paper on liver transplantation and pregnancy

Alisi¹,

Balsano²,

Bernabucci³

et al. 2016

Digestive and Liver Disease

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After the first successful pregnancy in a liver transplant recipient in 1978, much evidence has accumulated on the course, outcomes and management strategies of pregnancy following liver transplantation. Generally, liver transplantation restores sexual function and fertility as early as a few months after transplant. Considering that one third of all liver transplant recipients are women, that approximately one-third of them are of reproductive age (18-49 years), and that 15% of female liver transplant recipients are paediatric patients who have a >70% probability of reaching reproductive age, the issue of pregnancy after liver transplantation is rather relevant, and obstetricians, paediatricians, and transplant hepatologists ever more frequently encounter such patients. Pregnancy outcomes for both the mother and infant in liver transplant recipients are generally good, but there is an increased incidence of preterm delivery, hypertension/preeclampsia, foetal growth restriction, and gestational diabetes, which, by definition, render pregnancy in liver transplant recipients a high-risk one. In contrast, the risk of congenital anomalies and the live birth rate are comparable to those of the general population. Currently there are still no robust guidelines on the management of pregnancies after liver transplantation. The aim of this position paper is to review the available evidence on pregnancy in liver transplant recipients and to provide national Italian recommendations for clinicians caring for these patients.

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“…No work on dyslipidemia in patients undergoing liver transplantation to date has studied the relationship between the number of hours of sleep and this condition. [2][3][4]6 There are studies in the literature relating a higher number of hours of sleep per night and higher total cholesterol levels, but both increased (> 8 hours/day) and decreased (< 7 hours/day) sleep duration represent an increased risk of cardiovascular disease, diabetes and emergence of symptoms related to these conditions. 44 The primary explanation to the deleterious effects of a greater number of hours of sleep is related to the fact that people who sleep more have lower levels of daily physical activity and consequently reduced energy expenditure.…”

Section: 22-24mentioning

confidence: 99%

“…1 Many studies have described the high prevalence and incidence of this disorder in patients submitted to liver transplantation. [2][3][4][5][6] Furthermore, other cardiovascular risk factors, such as hypertension, obesity and diabetes have been commonly reported after liver transplants. 3,5,7 Therefore, patients submitted to this procedure have an increased risk of developing cardiovascular diseases -which have already been indicated as the third most common cause of death in this population by certain authors.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with dyslipidemia after liver transplantation

Ribeiro

Anastácio

Ferreira

et al. 2014

Rev. Assoc. Med. Bras.

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Prevalence and factors associated with dysliPidemia after liver transPlantation rev assoc med Bras 2014; 60(4):365-372 365Original articlePrevalence and factors associated with dyslipidemia after liver transplantation Conflict of interest: noneObjective: to determine the prevalence of abnormal total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides in patients undergoing liver transplantation (LTx) and to identify predictors of these disorders. Methods: cross-sectional study to assess the prevalence of dyslipidemia in patients undergoing LTx. Demographic, socioeconomic, clinical, anthropometric and dietetic data were collected to determine the association with dyslipidemia using univariate and multivariate statistical analysis. Results: 136 patients were evaluated, 68.1% of which had at least one type of dyslipidemia. The triglyceride level was high in 32.4% of cases, with low HDL in 49.3% of patients and high LDL levels in only 8.8%. High total cholesterol was observed in 16.2% of the study population and was associated with the recommendation for transplantation due to ethanolic cirrhosis (OR = 2.7) and a greater number of hours slept per night (OR = 1.5). Conclusion: many patients presented dyslipidemia after transplantation, demonstrating the need for interventions in relation to modifiable factors associated with dyslipidemias that can mitigate or prevent these disorders.

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Long-Term Complications and Survival of Patients After Orthotopic Liver Transplantation

Cited by 17 publications

References 7 publications

Liver transplantation: a systematic review of long‐term quality of life

Liver transplantation: a systematic review of long‐term quality of life

AISF position paper on liver transplantation and pregnancy

Prevalence and factors associated with dyslipidemia after liver transplantation

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