Influence of postoperative complications on long-term survival in liver transplant patients

Table 1 Donor and recipient features

Recipient variables
Gender, n (%)
Men	130 (79.3)
Women	34 (20.7)
Child
A	60 (36.8)
B	65 (39.9)
C	38 (23.3)
Indication, n (%)
OH	43 (26.7)
HPC	58 (36)
VHC	13 (8.1)
Retransplantation	13 (8.1)
Other	34 (20.7)
Age, mean ± SD	55.34 ± 9.55
BMI, mean ± SD	26.34 ± 4.27
Charlson index, mean ± SD	5.96 ± 2.06
MELD, mean ± SD	15.45 ± 6.93
BAR score, mean ± SD	6.14 ± 3.73
CCI score, mean ± SD	42.43 ± 25.01
Donor variables, mean ± SD
Age	61.59 ± 16.02
Cold ischemia (min)	327.03 ± 119.2
Donor type
Brain death	93.3%
Cardiac death	6.7%
Death cause cerebrovascular	80%
Trauma	12.7%
Other	7.3%

HPC: Hematopoietic progenitor cell; VHC: Venous hematocrit; BMI: Body mass index; MELD: Model for end-stage liver disease; BAR: Balance of risk; CCI: Comprehensive complication index.

Table 2 Postoperative complications and 5-yr survival, n (%)

Complications			5-yr Survival	Log rank
Acute rejection	Yes	10 (6.1)	55.1	0.857
	No	154 (93.3)	55.8
Arterial thrombosis	Yes	17 (10.4)	48.3	0.057
	No	147 (89.6)	56.5
Portal thrombosis	Yes	15 (9.1)	51.1	0.722
	No	149 (90.9)	54.5
Biliary stricture	Yes	15 (9.1)	54.7	0.898
	No	149 (90.9)	55.7
Biliary leak	Yes	38 (23.2)	55.4	0.574
	No	126 (76.8)	56.9
Wound infection	Yes	22 (13.4)	55.3	0.568
	No	142 (86.6)	58.8
Acute renal failure	No	89 (54.3)	58	0.237
	AKIN I	40 (24.4)	52.1
	AKIN II	18 (11)	53.2
	AKIN III	17 (10.4)	53.1
Death	Yes	13 (7.9)
	No	151 (92.1)

Table 3 Number of complications according to Clavien classification

Clavien	Number	Description (n)
0	9 (5.5)
I	4 (2.4)	Surgical wound hematoma (3)
		Postoperative ileus (1)
II	73 (44.5)	Portal thrombosis (5)
		Vena cava thrombosis (1)
		Intraabdominal hematoma (6)
		Intraabdominal abscess (2)
		Biliary leak (4)
		Surgical wound infection (7)
		Bacteriemia (2)
		Respiratory complication (8)
		Acute renal failure (19)
		Urinary tract infection (4)
		Acute rejection (3)
		Thrombocytopenia (1)
		Neurological alteration (5)
		Fever without a source (5)
		Hypocalcemia (1)
IIIa	22 (13.4)	Intraabdominal abscess (3)
		Biliary leak (12)
		Biliary stricture (6)
		Perforated diverticulitis (1)
IIIb	26 (15.9)	Arterial thrombosis (7)
		Portal thrombosis (2)
		Biliary leak (6)
		Biliary stricture (1)
		Hemoperitoneum (7)
		Vena cava leak (1)
		Abdominal hernia (1)
		Abdominal compartment syndrome (1)
IVa	16 (9.8)	Arterial thrombosis (4)
		Portal thrombosis (1)
		Biliary leak (1)
		Hemoperitoneum (7)
		Vena cava leak (2)
		Primary graft dysfunction (1)
IVb	1 (0.6)	Primary graft dysfunction (1)
V	13 (7.9)	Arterial thrombosis (4)
		Portal thrombosis (2)
		Hemoperitoneum (4)
		Ischemic cholangiopathy (1)
		Biliary stricture (1)
		Bilateral pneumonia (1)
Total	164 (100)

Table 4 Five-year survival according to comprehensive complication index, n (%)

CCI		5-yr Survival (mo)	Log-rank
< 20.9	12 (7.3)	60.0	0.167
≥ 20.9	152 (92.7)	50.7
< 33.5	78 (47.6)	57.4	< 0.001
≥ 33.5	86 (52.4)	45.7
< 36	88 (53.7)	57.6	< 0.001
≥ 36	76 (46.3)	43.9

CCI: Comprehensive complication index.

Table 5 Five-year survival multivariable analysis

Variables	P value	HR (95%CI)
BAR	0.101	0.922 (0.797-1.016)
Charlson index	0.58	0.764 (0.463-1.007)
CCI	< 0.001	0.941 (0.922-0.96)
HPC	0.311	0.277 ( 0.028-1.402)

BAR: Balance of risk; CCI: Comprehensive complication index; HPC: Hematopoietic progenitor cell.