{"title":"P-44 LONG-TERM SURVIVAL IN PATIENTS WITH LIVER TRANSPLANTATION","authors":"MARCIA SAMADA SUAREZ , Sheyla Moret Vara , Kenia Valenzuela Aguilera , Julio César Hernández Perera , Alejandro Roque Valdez , Norlan Bressler Hernández , Raimundo Blanco Selles , Maricet Fernández Díaz , Harlim Rodríguez Rodríguez , Mirtha Infante Velazquez","doi":"10.1016/j.aohep.2024.101658","DOIUrl":null,"url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Background: Liver transplant is the only effective treatment for acute or chronic liver diseases in the terminal stage. With advances in the management of immunosuppression and surgical techniques, survival is high, but it can decrease for different reasons depending on the time of evolution of the transplant. <em>Aim:</em> Determine long-term survival in patients with liver transplants and the main causes of mortality.</div></div><div><h3>Patients / Materials and Methods</h3><div>Methods: It is a descriptive, retrospective study in patients with liver transplant from a cadaveric donor, carried out at the Medical Surgical Research Center between 1999 and 2019, 117 patients with one year or more of survival were included. The main variables were causes of mortality and survival at 5, 10, 15 and 20 years, overall and by indication of the transplant (grouped into cirrhosis due to hepatitis B and C viruses, due to alcohol, autoimmune and other etiologies), which were obtained from the Liver Transplant Database. For the statistical analysis, summary measures were used according to the type of variable and the Kaplan Meier method for survival analysis.</div></div><div><h3>Results and Discussion</h3><div>Results: Of the 117 patients, 69 had died as of June 2024. Overall survival was 74.4%, 58.4%. 37.5% and 27.5% at 5, 10, 15 and 20 years respectively, with an overall mean of 13 years (95% CI 11.3-14.5), in relation to survival related to the etiology of the transplant the average was 9.3 years for viral cirrhosis, 9.9 for alcoholic etiology, 14.3 for autoimmune, and 15.8 years for others. The most frequent causes of long-term mortality were recurrence of the primary disease (20.5%) with a predominance of hepatitis C virus and de novo tumors (11.1%).</div></div><div><h3>Conclusions</h3><div>The mean long-term overall survival in patients with liver transplantation was greater than 10 years, with a negative impact of cirrhosis due to viruses and alcohol as an indication for transplant.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101658"},"PeriodicalIF":4.4000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of hepatology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1665268124004411","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/6 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Conflict of interest
No
Introduction and Objectives
Background: Liver transplant is the only effective treatment for acute or chronic liver diseases in the terminal stage. With advances in the management of immunosuppression and surgical techniques, survival is high, but it can decrease for different reasons depending on the time of evolution of the transplant. Aim: Determine long-term survival in patients with liver transplants and the main causes of mortality.
Patients / Materials and Methods
Methods: It is a descriptive, retrospective study in patients with liver transplant from a cadaveric donor, carried out at the Medical Surgical Research Center between 1999 and 2019, 117 patients with one year or more of survival were included. The main variables were causes of mortality and survival at 5, 10, 15 and 20 years, overall and by indication of the transplant (grouped into cirrhosis due to hepatitis B and C viruses, due to alcohol, autoimmune and other etiologies), which were obtained from the Liver Transplant Database. For the statistical analysis, summary measures were used according to the type of variable and the Kaplan Meier method for survival analysis.
Results and Discussion
Results: Of the 117 patients, 69 had died as of June 2024. Overall survival was 74.4%, 58.4%. 37.5% and 27.5% at 5, 10, 15 and 20 years respectively, with an overall mean of 13 years (95% CI 11.3-14.5), in relation to survival related to the etiology of the transplant the average was 9.3 years for viral cirrhosis, 9.9 for alcoholic etiology, 14.3 for autoimmune, and 15.8 years for others. The most frequent causes of long-term mortality were recurrence of the primary disease (20.5%) with a predominance of hepatitis C virus and de novo tumors (11.1%).
Conclusions
The mean long-term overall survival in patients with liver transplantation was greater than 10 years, with a negative impact of cirrhosis due to viruses and alcohol as an indication for transplant.
利益冲突前言与目的背景:肝移植是治疗急慢性肝病晚期的唯一有效方法。随着免疫抑制管理和手术技术的进步,生存率很高,但根据移植的发展时间,生存率可能因不同原因而降低。目的:确定肝移植患者的长期生存率及主要死亡原因。患者/材料和方法方法:这是一项描述性的回顾性研究,研究对象是1999年至2019年在医学外科研究中心进行的来自尸体供体的肝移植患者,其中包括117名生存期为一年或一年以上的患者。主要变量是从肝移植数据库获得的5年、10年、15年和20年的死亡率和生存率、总体和移植指征(分为乙型和丙型肝炎病毒导致的肝硬化、酒精、自身免疫和其他病因)。在统计分析中,根据变量类型采用汇总测量法,生存分析采用Kaplan Meier法。结果:截至2024年6月,117例患者中有69例死亡。总生存率分别为74.4%和58.4%。在5年、10年、15年和20年分别为37.5%和27.5%,总体平均为13年(95% CI 11.3-14.5),与移植病因相关的生存相关:病毒性肝硬化平均为9.3年,酒精病因平均为9.9年,自身免疫性平均为14.3年,其他病因平均为15.8年。长期死亡最常见的原因是原发疾病复发(20.5%),主要是丙型肝炎病毒和新生肿瘤(11.1%)。结论肝移植患者的平均长期总生存期大于10年,病毒和酒精所致肝硬化的负面影响是肝移植的指征。
期刊介绍:
Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.