Comparison of two periods in liver transplantation at Colombian medical center

Authors

  • Oscar Mauricio Santos-Sánchez Hospital Pablo Tobón Uribe
  • Octavio Germán Muñoz Hospital Pablo Tobón Uribe. Grupo de gastrohepatología, Universidad de Antioquia
  • Juan Ignacio Marín-Zuluaga Hospital Pablo Tobón Uribe, Medellín
  • Juan Carlos Restrepo Gutiérrez Hospital Pablo Tobón Uribe. Grupo de gastrohepatología, Universidad de Antioquia

DOI:

https://doi.org/10.22516/25007440.391

Keywords:

Liver transplanta, cirrhosis, liver graft, rejection, retransplatation

Abstract

Objective: Liver transplantation is the treatment of choice for acute and chronic liver failure. Liver transplantation results have improved in recent years, so the objective of our work was to compare results from two different periods of time at a center in Colombia.

Patients and Methods: This is a retrospective descriptive study comparing first time adult liver transplant patients from 2004-2010 (Series 1: 241 patients) and from 2011-2016 (Series 2: 142 patients).

Results: The average patient age was 54 years, 57% were men, and the average MELD score was 20. There were no significant differences between the characteristics of donors and recipients from one period to the next. The main indications for liver transplantation were alcoholic cirrhosis and cryptogenic and autoimmune hepatitis. Series 2 contained fewer hepatitis B and C cases than did Series 1. Thirty percent of the patients had hepatocellular carcinoma. The one-year survival rates were 81% in Series 1 and 91% in Series 2, whereas five-year survival rates were 71% and 80%, respectively. The main causes of death were cancer, cardiovascular disease and sepsis. From the first period to the second period, there was a significant increase in biliary complications but no differences in infectious complications, vascular complications or cellular rejection.

Conclusion: Short and medium term liver transplantation results at this center in Colombia have been excellent, but there have been significant improvements in patient survival rates in recent years that are similar to those reported elsewhere in the world.

Downloads

Download data is not yet available.

Author Biographies

Oscar Mauricio Santos-Sánchez, Hospital Pablo Tobón Uribe

Unidad de hepatología y trasplante hepático, Medellín

Octavio Germán Muñoz, Hospital Pablo Tobón Uribe. Grupo de gastrohepatología, Universidad de Antioquia

Unidad de hepatología y trasplante hepático, Medellín

Juan Ignacio Marín-Zuluaga, Hospital Pablo Tobón Uribe, Medellín

Unidad de hepatología y trasplante hepático

Juan Carlos Restrepo Gutiérrez, Hospital Pablo Tobón Uribe. Grupo de gastrohepatología, Universidad de Antioquia

Unidad de hepatología y trasplante hepático. Grupo de gastrohepatología

References

European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Liver transplantation. J Hepatol. 2016 Feb;64(2):433-485. https://doi.org/10.1016/j.jhep.2015.10.006

Santos O, Londoño M, Marín J, Muñoz O, Mena Á, Guzmán C, et al. An experience of liver transplantation in Latin America: a medical center in Colombia. Colomb Med (Cali). 2015 Mar 30;46(1):8-13. https://doi.org/10.25100/cm.v46i1.1400

Thuluvath PJ, Guidinger MK, Fung JJ, Johnson LB, Rayhill SC, Pelletier SJ. Liver transplantation in the United States, 1999-2008. Am J Transplant. 2010 Apr;10(4 Pt 2):1003-19. https://doi.org/10.1111/j.1600-6143.2010.03037.x

Adam R, Karam V, Delvart V, O'Grady J, Mirza D, Klempnauer J, et al. Evolution of indications and results of liver transplantation in Europe. A report from the European Liver Transplant Registry (ELTR). J Hepatol. 2012 Sep;57(3):675-88. https://doi.org/10.1016/j.jhep.2012.04.015

De Bona M, Ponton P, Ermani M, Iemmolo RM, Feltrin A, Boccagni P, et al. The impact of liver disease and medical complications on quality of life and psychological distress before and after liver transplantation. J Hepatol. 2000 Oct;33(4):609-15. https://doi.org/10.1016/S0168-8278(00)80012-4

Kotton CN, Kumar D, Caliendo AM, Asberg A, Chou S, Danziger-Isakov L, et al. Updated international consensus guidelines on the management of cytomegalovirus in solid-organ transplantation. Transplantation. 2013 Aug 27;96(4):333-60. https://doi.org/10.1097/TP.0b013e31829df29d

Fung J, Wong T, Chok K, Chan A, Cheung TT, Dai JW, et al. Long-term outcomes of entecavir monotherapy for chronic hepatitis B after liver transplantation: Results up to 8 years. Hepatology. 2017 Oct;66(4):1036-1044. https://doi.org/10.1002/hep.29191

Lucey MR, Terrault N, Ojo L, Hay JE, Neuberger J, Blumberg E, et al. Long-term management of the successful adult liver transplant: 2012 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation. Liver Transpl. 2013 Jan;19(1):3-26. https://doi.org/10.1002/lt.23566

Kim WR, Lake JR, Smith JM, Schladt DP, Skeans MA, Harper AM, et al. OPTN/SRTR 2016 Annual Data Report: Liver. Am J Transplant. 2018 Jan;18 Suppl 1:172-253. https://doi.org/10.1111/ajt.14559.

Londoño JF, Agudelo Y, Guevara G, Cardona D. Factores clínicos y demográficos asociados con la supervivencia de los pacientes mayores de 14 años con trasplante hepático, en el hospital universitario de San Vicente Fundación, 2002 a 2013. Rev Col Gastroenterol. 2016 Sep;31(3): 208-215. https://doi.org/10.22516/25007440.92

Meirelles Júnior RF, Salvalaggio P, Rezende MB, Evangelista AS, Guardia BD, Matielo CE, et al. Liver transplantation: history, outcomes and perspectives. Einstein (Sao Paulo). 2015 Jan-Mar;13(1):149-52. https://doi.org/10.1590/S1679-45082015RW3164

Mattos ÂZ, Mattos AA, Sacco FK, Hoppe L, Oliveira DM. Analysis of the survival of cirrhotic patients enlisted for liver transplantation in the pre- and post-MELD era in southern Brazil. Arq Gastroenterol. 2014 Jan-Mar;51(1):46-52. https://doi.org/10.1590/S0004-28032014000100010

Cejas NG, Villamil FG, Lendoire JC, Tagliafichi V, Lopez A, Krogh DH, et al. Improved waiting-list outcomes in Argentina after the adoption of a model for end-stage liver disease-based liver allocation policy. Liver Transpl. 2013 Jul;19(7):711-20. https://doi.org/10.1002/lt.23665

Piñero F, Cheang Y, Mendizabal M, Cagliani J, Gonzalez Campaña A, Pages J, et al. Incidence, risk factors, and outcomes related with neurological events after liver transplantation in adult and pediatric recipients. Pediatr Transplant. 2018 May;22(3):e13159. https://doi.org/10.1111/petr.13159

Muller X, Marcon F, Sapisochin G, Marquez M, Dondero F, Rayar M, et al. Defining Benchmarks in Liver Transplantation: A Multicenter Outcome Analysis Determining Best Achievable Results. Ann Surg. 2018 Mar;267(3):419-425. https://doi.org/10.1097/SLA.0000000000002477

VanWagner LB, Lapin B, Levitsky J, Wilkins JT, Abecassis MM, Skaro AI, et al. High early cardiovascular mortality after liver transplantation. Liver Transpl. 2014 Nov;20(11):1306-16. https://doi.org/10.1002/lt.23950

Watt KD, Pedersen RA, Kremers WK, Heimbach JK, Sanchez W, Gores GJ. Long-term probability of and mortality from de novo malignancy after liver transplantation. Gastroenterology. 2009 Dec;137(6):2010-7. https://doi.org/10.1053/j.gastro.2009.08.070

Kotton CN, Kumar D, Caliendo AM, Huprikar S, Chou S, Danziger-Isakov L, et al. The Third International Consensus Guidelines on the Management of Cytomegalovirus in Solid-organ Transplantation. Transplantation. 2018 Jun;102(6):900-931. https://doi.org/10.1097/TP.0000000000002191

Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, Montalto F, Ammatuna M, Morabito A, Gennari L. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996 Mar 14;334(11):693-9. https://doi.org/10.1056/NEJM199603143341104

Díaz-Ramírez GS, Marín-Zuluaga JI, Donado-Gómez JH, Muñoz-Maya O, Santos-Sánchez Ó, Restrepo-Gutiérrez JC. Characterization of patients with autoimmune hepatitis at an university hospital in Medellín-Colombia: cohort study. Gastroenterol Hepatol. 2018 Feb;41(2):87-96. https://doi.org/10.1016/j.gastrohep.2017.09.003

Published

2019-07-02

How to Cite

Santos-Sánchez, O. M., Muñoz, O. G., Marín-Zuluaga, J. I., & Restrepo Gutiérrez, J. C. (2019). Comparison of two periods in liver transplantation at Colombian medical center. Revista Colombiana De Gastroenterología, 34(2), 117–124. https://doi.org/10.22516/25007440.391

Issue

Section

Originals articles

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code

Some similar items: