Post Liver Transplantation Survival and Related Prognostic Factors among Adult Recipients in Tehran Liver Transplant Center; 2002–2019

Abstract

Background: Liver transplantation is a standard treatment for patients with end-stage liver disease (ESLD). However, with increasing demand for this treatment and limited resources, it is available only to patients who are more likely to survive. The primary aim was to determine prognostic factors for survival. Methods: We collected data from 597 adult patients with ESLD, who received a single organ and initial orthotopic liver transplantation (OLT) in our center between 20 March 2008 and 20 March 2018. In this historical cohort study, univariate and multiple Cox model were used to determine prognostic factors of survival after transplantation. Results: After a median follow-up of 825 (0–3889) days, 111 (19%) patients died. Survival rates were 88%, 85%, 82% and 79% at 90 days, 1 year, 3 years, and 5 years, respectively. Older patients (HR = 1.27; 95% CI: 1.01–1.59), presence of pre-OLT ascites (HR = 2.03; 95% CI: 1.16–3.57), pre-OLT hospitalization (HR = 1.88; 95% CI:1.02–3.46), longer operative time (HR = 1.006; 95% CI: 1.004–1.008), post-OLT dialysis (HR = 3.51; 95% CI: 2.07–5.94), cancer (HR = 2.69; 95% CI: 1.23–5.89) and AID (HR = 2.04; 95% CI: 1.17–3.56) as underlying disease versus hepatitis, and higher pre-OLT creatinine (HR = 1.67; 95% CI: 1.10–2.52) were associated with decreased survival. Conclusion: In this center, not only are survival outcomes excellent, but also younger patients, cases with better pre-operative health conditions, and those without complications after OLT have superior survival.