A comparison of outcomes between liver transplant recipients in China and those in Taiwan

Teng-Wei Chen, Chih-Yung Yu, Heng-Cheng Chu, De-Chuan Chan, Guo-Shiou Liao, Chung-Bao Hsieh

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Abstract

Background: The outcome of liver transplantation in Taiwan and overseas has not been compared directly. We investigated differences in outcomes between liver transplant recipients in China and those in Taiwan. Materials and Methods: Ninety-two patients who underwent liver transplantation in China and were subsequently being followed at the Tri- Service General Hospital (TSGH; China group; CG) were compared with 107 patients who received transplants at TSGH (Taiwan group; TG). Donor and recipient characteristics, complications, and survival were analyzed. Survival was calculated using the Kaplan-Meier method, and univariate analysis was tested by the log-rank test. Then, regression analysis was performed using the Cox proportional hazard model. Results: The number of patients with hepatocellular carcinoma (HCC) beyond the Milan and University of California, San Francisco criteria was signifi cantly higher in the CG than in the TG. The rates of HCC recurrence, intrahepatic biliary strictures, and mortality were also higher in the CG than in the TG. Univariate analysis revealed signifi cant differences in 8 parameters between survivors and non-survivors, and Cox regression analysis further identifi ed psychosocial problems, post-transplant de novo malignancy, HCC recurrence, and graft failure as mortality predictors. The overall survival rate was signifi cantly higher in the TG than in the CG, with the former group showing a trend of greater mean survival duration. However, differences in survival were not signifi cant after adjusting for risk factors. Conclusion: The outcomes of patients receiving livers donated after cardiac death may be comparable; however, patients with advanced HCC should not seek transplantation without appropriate pre-transplant tumor treatments. © 2013 JMS.
Original languageEnglish
Pages (from-to)311-319
Number of pages9
JournalJournal of Medical Sciences (Taiwan)
Volume33
Issue number6
DOIs
Publication statusPublished - 2013
Externally publishedYes

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Keywords

  • Brain death
  • Donation after cardiac death
  • Down-stage therapy
  • Liver transplantation
  • Survival
  • adult
  • article
  • bile leakage
  • cancer recurrence
  • cerebrovascular accident
  • China
  • cholangitis
  • cholestasis
  • common bile duct stone
  • erythrophagocytosis
  • female
  • graft failure
  • hepatitis B
  • human
  • liver cell carcinoma
  • liver transplantation
  • major clinical study
  • male
  • middle aged
  • mortality
  • overall survival
  • risk factor
  • Taiwan
  • treatment outcome

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