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Volume 3 Supplement 1

ESICM LIVES 2015

  • Poster presentation
  • Open Access

Analysis of the outcome of liver transplantation patients in india - a prospective observational study

  • 1,
  • 2,
  • 2,
  • 1,
  • 1 and
  • 1
Intensive Care Medicine Experimental20153 (Suppl 1) :A697

https://doi.org/10.1186/2197-425X-3-S1-A697

  • Published:

Keywords

  • Renal Replacement Therapy
  • Hospital Mortality
  • Brain Death
  • Portal Vein Thrombosis
  • Hospital Length

Introduction

Liver transplantation has become a widely accepted therapy for the management of the complications of cirrhosis and liver failure.

Objectives

To analyze the patients undergoing the Liver transplant Recipients and the factors influencing the outcome of the patients at our tertiary care hospital.

Methods

The patients underwent liver transplantation recepients between May 2014 to Jan 2015 were analysed. The data was collected from patient records after ethics committee approval. The data captured were Age,sex, ICU and hospital length of stay, bilirubin, albumin, INR, creatinine, intubation days, readmission,cold ischemia, warm ischemia, portal vein thrombosis, SGOT, SGPT, Vasopressors use, APACHE II, SOFA Score, MELD Score, arterial anatomy, graft complications, hospital and 60day mortality, readmissions, hospital acquired infections are monitored.

Results

The total number of patients enrolled are 34. See tables 1, 2 and 3
Table 1

Demographic data of the transplant receipients.

Variable

Mean n (%)

Age in years

49.5

Sex Male

27 (79.41)

Cause of liver transplant (Alcohol cirrhosis)

20 (58.82)

APACHE II at admission

12.59

SOFA at admission

7

MELD Score

20.35

No Comorbidities

26 (76%)

INR

2.6

Total bilirubin mg/dl

4.51

Table 2

Outcome data of transplant patients.

Variable

Mean

ICU length of stay in days

4.85

Hospital length of stay in days

15.18

Cold ischemia time in minutes

243

Warm ischemia time in minutes

45.06

Ventilator days

0.85

Blood products received (PRBC)

9.41

Albumin mg/dl

2.91

Creatinine mg/dl

1.23

Max SGOT U/L / Max SGPT U/L / Lowest Platelets 10/mm

1227 / 592 / 42.3

Table 3

Mortality and other outcomes of the patients.

Variable

Number

Percentage

Graft Whole / partial

26 / 8

76.5 / 23.5

Mortality

1

2.94

Arterial anatomy abnormality

4

11.76

Renal Replacement therapy

1

2.94

Vasopressors use

5

14.71

Readmission

2

5.89

Portal Vein Thrombosis

2

5.89

The hospital mortality rate in our study is 2.94% (one patient).

All the patients are ABO compatable, 2 patients had early graft rejection of which one patient liver functions has completely recovered and the other had not fully recovered. The hospital acquired infections are nil in these patients.

26 (76.47%) liver donors are brain death patients. 5 (14.71%) receipient patients are HCV positive. The factors increasing the the mortality are Increased ICU and hospital length of stay, reintubation, readmission and renal replacement therapy.

The statistically significant factors which increase the ICU length of stay are increased Bilurubin, decreased Albumin, increased ventilator days, increased Cold Ischemia and Warm Ischemia time, use of Vasopressors, lowest Platelets and raised INR.

The statistically significant factors which increase the Hospital length of stay are decreased Albumin, increased ventilator days, reintubation, use of Vasopressors, readmission and lower platelets. The 60 day mortality is similar to hospital mortality.

Conclusions

The patients undergoing the Liver transplant Recipients had good outcomes with less mortality and is comparable to the best centres in the world.

Hospital acquired infections are nil in these patients.

We need larger number to analyse the patients.

Authors’ Affiliations

(1)
Apollo Health City, Critical Care Medicine, Hyderabad, India
(2)
Department of Hepatopancreatic Biliary Surgery, Apollo Health City, Hyderabad, India

References

  1. Long-Term Survival After Liver Transplantation in 4,000 Consecutive Patients at a Single Center. Ann Surg. 2000, 232 (4): 490-500. 10.1097/00000658-200010000-00004. OctGoogle Scholar

Copyright

© Jakkinaboina et al.; 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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