Outcomes after liver transplantation in korea: Incidence and risk factors from korean transplantation registry

Jong Man Kim, Deok Gie Kim, Jihyun Kim, Keunsung Lee, Kwang Woong Lee, Je Ho Ryu, Bong Wan Kim, Dong Lak Choi, Young Kyoung You, Dong Sik Kim, Yang Won Nah, Koo Jeong Kang, Jai Young Cho, Geun Hong, Hee Chul Yu, Ju Ik Moon, Dongho Choi, Shin Hwang, Myoung Soo Kim

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Background/Aims: To analyze the incidence and risk factors of outcomes after liver transplantation (LT) in the Korean population. Methods: This study analyzed data from the liver cohort of Korean Organ Transplantation Registry (KOTRY) who had LT between May 2014 and December 2017. Study measures included the incidence of post-LT outcomes in recipients of living donor LT (LDLT) and deceased donor LT (DDLT). Cox multivariate proportional hazards model was used to determine the potential risk factors predicting the outcomes. Results: A total of 2,563 adult recipients with LT (LDLT, n=1,956; DDLT, n=607) were included, with mean±standard deviation age of 53.9±8.9 years, and 72.2% were male. The post-LT outcomes observed in each LDLT and DDLT recipients were death (4.0% and 14.7%), graft loss (5.0% and 16.1%), rejection (7.0% and 12.0%), renal failure (2.7% and 13.8%), new onset of diabetes (12.5% and 15.4%), and hepatocellular carcinoma (HCC) recurrence (both 6.7%). In both LDLT and DDLT recipients, the most common post-LT complications were renal dysfunction (33.6% and 51.4%), infection (26.7% and 48.4%), and surgical complication (22.5% and 23.9%). Incidence of these outcomes were generally higher among recipients of DDLT than LDLT. Multivariate analysis indicated recipient age and DDLT as significant risk factors associated with death and graft loss. DDLT and ABO incompatible transplant were prognostic factors for rejection, and HCC beyond Milan criteria at pre-transplant was a strong predictor of HCC recurrence. Conclusions: This study is a good indicator of the post-LT prognosis in the Korean population and suggests a significant burden of post-LT complications.

Original languageEnglish
JournalClinical and molecular hepatology
Volume27
Issue number3
DOIs
StatePublished - Jul 2021

Keywords

  • Incidence
  • Liver transplantation
  • Renal insufficiency
  • Risk factors

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