Long-Term Survival after Orthotopic Liver Transplant: 20-year analysis at a Transplant Center in Campinas, Brazil
Introduction: Orthotopic liver transplantation (OLT) is the primary therapy for end-stage liver disease. In Brazil, the number of liver transplants has significantly increased over the past decades, improving long-term outcomes. This study analyzes the long-term survival of patients who underwent O...
| Autores: | , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | Brasil |
| Institución: | Associação Brasileira de Transplante de Órgãos (ABTO) |
| Repositorio: | Brazilian Journal of Transplantation |
| Idioma: | inglés portugués |
| OAI Identifier: | oai:ojs3.emnuvens.com.br:article/633 |
| Acceso en línea: | https://bjt.emnuvens.com.br/revista/article/view/633 |
| Access Level: | acceso abierto |
| Palabra clave: | Transplante de Fígado Sobrevida Insuficiência Hepática Doença Hepática Crônica Mortalidade Hospitalar Fatores Prognósticos Liver Transplantation Survivorship Hepatic Insufficiency Chronic Liver Disease Hospital Mortality Prognostic Factors |
| Sumario: | Introduction: Orthotopic liver transplantation (OLT) is the primary therapy for end-stage liver disease. In Brazil, the number of liver transplants has significantly increased over the past decades, improving long-term outcomes. This study analyzes the long-term survival of patients who underwent OLT over 20 years at a reference transplant center. Methods: Medical records of 848 patients who underwent OLT between February 1995 and December 2017 were reviewed. Exclusion criteria included patients with survival below six months to minimize the impact of early postoperative complications on long-term outcomes. Thus, 174 patients were included. The analyzed variables involved the recipient, donor, graft, surgical procedure, and postoperative evolution. Survival was assessed using Kaplan–Meier analysis. Results: Among the 174 analyzed patients, 98 (56.3%) remained in outpatient follow-up, while 76 (43.7%) died. The mean age at transplantation was 47 years, and 75% of recipients were male. The main indications were viral hepatitis (59.8%) and hepatocellular carcinoma (11.6%). The mean MELD score was 18. The leading cause of death was cardiovascular events (36.4%), followed by liver disease recurrence (22.1%) and malignancies (15.6%). The mean survival time was 223 months for surviving patients and 112 months for deceased patients (p 0.0001). Longer cold ischemia time, postoperative renal dysfunction, diabetes, and prolonged stay in the intensive care unit were associated with worse survival. Younger patients had significantly longer survival (p = 0.00007). Conclusion: The 20-year analysis demonstrated that OLT provides good long-term survival; however, factors such as diabetes, renal dysfunction, and prolonged cold ischemia time negatively impact the outcomes. Cardiovascular events and recurrence of liver disease were the leading causes of mortality. |
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