Postoperative One Month Follow-up for Survival, Complications and Value of MELD score in Predicting Mortality in Living Donor Liver Transplantation (LDLT) Recipients; A Multi- Center Study,YASSER NASSAR, AHMED BATTAH, KHALID OMAR and AHMED MOWAFY
Abstract
Background: Living donor liver transplantation has emerged as a surgical technical achievement designed to increase the organ supply. Adult recipients have a wide range of disease severity and higher incidence of medical co-morbidities, in addition, the use of a partial graft in an adult recipient predisposes the recipient to a unique set of potential technical and anatomic complications that are not prevalent in whole deceased donor grafts.
Objectives: Assessment and 30 days follow-up of post-operative LDLT recipients and monitoring for complications.
Methods: A retrospective study involving 142 patients that underwent LDLT in two centers, International Medical Center “IMC” 113 cases and Kasr Al Aini hospital 29 cases, in the period from October 2004 to December 2010, were recruited in the study. Post-operatively, daily assessment was done, by recording and following-up all the clinical laboratory and radiological data, for a period of 30 days.
Results: The survival rate recorded at our study was 86.62%. The most frequent complications were renal compli-cations (86.6%), pulmonary complications (73.9%), neurolog-ical complications (14%), cardiovascular complications (12.6%), infectious complications (13.3%), intra-abdominal infections (10.5%) and immunosuppressant toxicity (7.7%). MELD score proved to be a good predictor of perioperative outcome, patients with MELD score (>12) was associated with less favorable outcome, accuracy was (80.3%).
Conclusion: LDLT is a comparatively safe and effective procedure for well-selected categories of patients regarding outcome mortality, medical and surgical complications. MELD score of (>12) was associated with less favorable outcome, accuracy was (80.3%).