부산대학교 도서관

The current liver allocation system requires reevaluation because of the advancements in peri-transplantation care and surgical techniques. And, the role of living donor liver transplantation ( LDLT) in an emergency has not been determined yet. Retrospective review of all patients undergoing emergency liver transplantation ( LT) from January 2000 to June 2010 was conducted, and clinical data were analyzed. Of the total 505 LTs, 69 patients (13.7%) underwent an emergency LT. Of these, 54 patients (78.3%) underwent LDLT using a right liver, and 15 patients (21.7%) underwent deceased donor liver transplantation ( DDLT). The overall hospital mortality was 21.7% (15/69). The leading cause of death after transplantation was sepsis (60.0%). Multivariate analysis demonstrated that a model for end-stage liver disease ( MELD) >33 [hazard ratio ( HR), 16.6; 95% confidence interval ( CI), 1.443-191.632; p = 0.024] and existence of pre-transplantation intubation ( HR, 18.2; 95% CI, 1.463-225.483; p = 0.024) were independent factors associated with poor survival after emergency LT. LDLT group and DDLT group showed no difference in hospital mortality (p = 0.854) and graft survival (p = 0.861). Thus, MELD score and respiratory insufficiency could be parameters predicting post-transplant survival. And, LDLT using the right liver could be an appropriate alternative to DDLT in an emergency. [ABSTRACT FROM AUTHOR]