Yüksek MELD-Na Skoru ile Canlı Donörden Karaciğer Transplantasyonu Planlanan Hastalarda Erken Dönem Sonuçlarımız: Tek Merkez Deneyimi
Abstract
Objectives: Living donor liver transplantation (LDLT) can be performed more frequently due to insufficient cadaver organ donation. In cases where the number of cadaveric organ is not sufficient patients with high MELD-Na score stand out during waiting. In this study, the effect of high MELDNa score on early postoperative outcome was investigated in LDLT.
Materials and Methods: In our study, adult patients with a MELD-Na score of ≥25 between January 2015 and December 2021 were evaluated retrospectively. According to the preoperative MELD-Na score calculated after the treatments applied during the preparation period, the patients were divided into two groups as <25 or ≥25 and evaluated for mortality and complications.
Results: Fourteen of 43 patients with MELD-Na ≥25 were female (32.6%) and 29 were male (67.4%). The mean age was 48.12±11.89 years. The mean MELD-Na score calculated when planning LDLT was 28.93±4.10 and the preoperative MELD-Na score was 23.72±5.9. Plasmapheresis was applied to 20% of patients during the preoperative period. Complications developed in 81.4% of patients. Bleeding (60.5%), surgical bleeding (11.6%) and acute kidney injury (16.3%) were the most common complications. The mortality rate for the 1st month was 9.3% and the mortality rate for the 3rd month was 16.3%. Patients with a preoperative MELD-Na score of ≥25 were found to have a higher hyponatremia rate (73.3%), against MELD-Na <25 (26.7%, p<0.002) while postoperative early morbidity and mortality rates were comparable.
Conclusion: LDLT patients with the high MELD-Na scores often have a chance of preparing period for surgery in elective conditions, so when they are optimized preoperatively, better results may obtained in terms of both early complications and mortality rates.
Keywords
Liver Transplantation, Hyponatremia, Postoperative Complication, Survival
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