• Mohammed A Nafea, Ayman Alsebaey, Ahmed Abd El Aal Sultan, Mohammed Hisham Goda, Ahmed Salman, Hanaa Said Rashed, Ahmed Soliman, Mai Elshenoufy, and Mostafa Abdelrahman.
• From the Department of General Surgery, Al-Azhar University, Cairo, Egypt.
• Ann Saudi Med. 2019 Sep 1; 39 (5): 337344337-344.

BackgroundLiving donor liver transplantation (LDLT) has evolved into a widely accepted therapeutic option. Many different risk factors may affect early mortality after LDLT.ObjectivesAnalyze risk factors that can affect early (<6 months) mortality of patients after LDLT in a single center.DesignRetrospective chart review of patients who underwent LDLT.SettingUniversity hospital.Patients And MethodsAdult cirrhotic patients who underwent LDLT were classified by early (first 6 months) or late mortality. A full pre, intra- and post-operative evaluation had been done on all patients including a full history, examination and investigations to identify risk factors that might affect mortality post-LDLT.Main Outcome MeasuresDetermination of pre-, intra- or postoperative factors that might affect recipient mortality post-LDLT.Sample Size123.ResultsPre-operative factors that increased early mortality in a univariate analysis were higher model for end-stage liver disease (MELD) scores, lower graft-recipient weigh ratio (GRWR), older donor age, and recurrent spontaneous bacterial peritonitis. Intraoperative factors included more transfusion units of blood, plasma, platelets and cryoprecipitate, a longer time for cold and warm ischemia, and a longer anhepatic phase among others. Postoperative factors included a longer ICU or hospital stay and abnormal postoperative laboratory data. In the final logistic regression model, the most significant factors were pre-operative GRWR, length of hospital stay, units of intraoperative blood transfusion, postoperative alanine aminotransferase, postoperative total leukocyte count, and MELD score.ConclusionLDLT outcomes might be improved by attempting to resolve clinical factors that have been identified as contributors to early post-LDLT mortality.LimitationsMore risk factors, such as those relevant to patient portal vein hemodynamics, should be included in an analysis of predictors of early mortality.Conflict Of InterestNone.

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