Pretransplantation risk factors for graft loss after liver transplantation in cirrhotic patients;: effect of cytomegalovirus serologic status

被引:4
作者
Castellví, JM
Xiol, X
Guardiola, J
Sabaté, I
Roca, M
Lama, C
Figueras, J
Jaurrieta, E
Casais, L
机构
[1] Hosp Mataro, Dept Gastroenterol, Barcelona 08304, Spain
[2] Hosp Llobregat, Ciutat Sanitaria Univ Bellvitge, Dept Gastroenterol, Barcelona, Spain
[3] Hosp Llobregat, Ciutat Sanitaria Univ Bellvitge, Dept Biochem, Barcelona, Spain
[4] Hosp Alt Penedes, Gastroenterol Unit, Barcelona, Spain
[5] Hosp Llobregat, Ciutat Sanitaria Univ Bellvitge, Dept Nucl Med, Barcelona, Spain
[6] Hosp Llobregat, Ciutat Sanitaria Univ Bellvitge, Dept Surg, Barcelona, Spain
关键词
prognosis; liver transplantation; cytomegalovirus;
D O I
10.1007/s00147-004-0684-9
中图分类号
R61 [外科手术学];
学科分类号
摘要
This study analyzes the effect of the preoperative variables of donors and recipients on graft survival after liver transplantation (LT). Preoperative data from a cohort of 122 cirrhotic patients who underwent primary LT were evaluated prospectively. The influence of these variables as risk factors for graft loss was assessed. During follow-up (median: 33 (19-59) months) there were 38 (31.1%) graft losses (22 deaths and 16 retransplantations). Variables that showed statistical association with graft loss on univariate analysis (P<0.150) were: positivity of the CMV serologic status of the donor (P=0.028), the UNOS score of recipient (P=0.048) and advanced donor age (P=0.124). When these variables were introduced into the multivariate study, the CMV serologic status of the donor was the only variable that was independently associated with graft loss (relative risk=2.97, 95% confidence interval=1.05-8.39; P=0.039). Donor CMV-seropositivity is a significant pretransplantation determinant for graft loss in liver transplant recipients.
引用
收藏
页码:131 / 137
页数:7
相关论文
共 31 条
[1]   Normalised intrinsic mortality risk in liver transplantation: European Liver Transplant Registry study [J].
Adam, R ;
Cailliez, V ;
Majno, P ;
Karam, V ;
McMaster, P ;
Calne, RY ;
O'Grady, J ;
Pichlmayr, R ;
Neuhaus, P ;
Otte, JB ;
Hoeckerstedt, K ;
Bismuth, H .
LANCET, 2000, 356 (9230) :621-627
[2]  
BALIGA P, 1992, SURGERY, V112, P704
[3]   PROGNOSTIC VALUE OF PREOPERATIVELY OBTAINED CLINICAL AND LABORATORY DATA IN PREDICTING SURVIVAL FOLLOWING ORTHOTOPIC LIVER-TRANSPLANTATION [J].
CUERVASMONS, V ;
MILLAN, I ;
GAVALER, JS ;
STARZL, TE ;
VANTHIEL, DH .
HEPATOLOGY, 1986, 6 (05) :922-927
[4]  
Deschenes M, 1997, Liver Transpl Surg, V3, P532, DOI 10.1002/lt.500030509
[5]   PROGNOSIS IN PRIMARY BILIARY-CIRRHOSIS - MODEL FOR DECISION-MAKING [J].
DICKSON, ER ;
GRAMBSCH, PM ;
FLEMING, TR ;
FISHER, LD ;
LANGWORTHY, A .
HEPATOLOGY, 1989, 10 (01) :1-7
[6]   Assessing risk in liver transplantation - Special reference to the significance of a positive cytotoxic crossmatch [J].
Doyle, HR ;
Marino, IR ;
Morelli, F ;
Doria, C ;
Aldrighetti, L ;
McMichael, J ;
Martell, J ;
Gayowski, T ;
Starzl, TE .
ANNALS OF SURGERY, 1996, 224 (02) :168-177
[7]   CYTOMEGALOVIRUS-INFECTION AND PNEUMONITIS - IMPACT AFTER ISOLATED LUNG TRANSPLANTATION [J].
ETTINGER, NA ;
BAILEY, TC ;
TRULOCK, EP ;
STORCH, GA ;
ANDERSON, D ;
RAAB, S ;
SPITZNAGEL, EL ;
DRESLER, C ;
COOPER, JD .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1993, 147 (04) :1017-1023
[8]   An association between cytomegalovirus infection and chronic rejection after liver transplantation [J].
Evans, PC ;
Soin, A ;
Wreghitt, TG ;
Taylor, CJ ;
Wight, DGD ;
Alexander, GJM .
TRANSPLANTATION, 2000, 69 (01) :30-35
[9]   Effect of cytomegalovirus infection status on first-year mortality rates among orthotopic liver transplant recipients [J].
Falagas, ME ;
Syndman, DR ;
Griffith, J ;
Ruthazer, R ;
Werner, BG ;
Rohrer, R ;
Freeman, R ;
Fairchild, R ;
Fawaz, K ;
Hoffman, MA ;
Kaplan, M ;
Gill, M ;
Rubin, RH ;
Dienstag, JL ;
Doran, M ;
ORourke, E ;
Vacanti, J ;
Jenkins, R ;
Lewis, WD ;
Hammer, S ;
Martin, M ;
Grady, GF ;
Leszczynski, J ;
Dougherty, N ;
Katz, A ;
Fausett, G ;
Platt, R ;
Cheeseman, SH ;
Pasternack, M ;
Gorbach, SL .
ANNALS OF INTERNAL MEDICINE, 1997, 126 (04) :275-+
[10]   Exposure to cytomegalovirus from the donated organ is a risk factor for bacteremia in orthotopic liver transplant recipients [J].
Falagas, ME ;
Snydman, DR ;
Griffith, J ;
Werner, BG ;
Rohrer, R ;
Freeman, R ;
Fawaz, K ;
Hoffman, MA ;
Kaplan, M ;
Gill, M ;
Rubin, RH ;
Dienstag, JL ;
Doran, M ;
ORourke, E ;
Vacanti, J ;
Jenkins, R ;
Lewis, WD ;
Hammer, S ;
Martin, M ;
Fairchild, R ;
Grady, GF ;
Leszczynski, J ;
Dougherty, N ;
Katz, A ;
Fausett, G ;
Platt, R ;
Cheeseman, SH ;
Pasternack, M ;
Gorbach, SL .
CLINICAL INFECTIOUS DISEASES, 1996, 23 (03) :468-474