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High MELD score and extended operating time predict prolonged initial ICU stay after liver transplantation and influence the outcome.

ABSTRACT: BACKGROUND:The aim of the present study is to determine the incidence of a prolonged (>3 days) initial ICU-stay after liver transplantation (LT) and to identify risk factors for it. PATIENTS AND METHODS:We retrospectively analyzed data of adult recipients who underwent deceased donor first-LT at the University Hospital Essen between 11/2003 and 07/2012 and showed a primary graft function. RESULTS:Of the 374 recipients, 225 (60.16%) had prolonged ICU-stay. On univariate analysis, donor INR, high doses of vasopressors, "rescue-offer" grafts, being hospitalized at transplant, high urgency cases, labMELD, alcoholic cirrhosis, being on renal dialysis and length of surgery were associated with prolonged ICU-stay. After multivariate analysis, only the labMELD and the operation's length were independently correlated with prolonged ICU-stay. Cut-off values for these variables were 19 and 293.5 min, respectively. Hospital stay was longer for patients with a prolonged initial ICU-stay (p<0.001). Survival rates differed significantly between the two groups at 3 months, 1-year and 5-years after LT (p<0.001). CONCLUSIONS:LabMELD and duration of LT were identified as independent predictors for prolonged ICU-stay after LT. Identification of recipients in need of longer ICU-stay could contribute to a more evidenced-based and cost-effective use of ICU facilities in transplant centers.

SUBMITTER: Stratigopoulou P

PROVIDER: S-EPMC5358862 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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High MELD score and extended operating time predict prolonged initial ICU stay after liver transplantation and influence the outcome.

Stratigopoulou Panagiota P Paul Andreas A Hoyer Dieter P DP Kykalos Stylianos S Saner Fuat H FH Sotiropoulos Georgios C GC

PloS one 20170320 3

<h4>Background</h4>The aim of the present study is to determine the incidence of a prolonged (>3 days) initial ICU-stay after liver transplantation (LT) and to identify risk factors for it.<h4>Patients and methods</h4>We retrospectively analyzed data of adult recipients who underwent deceased donor first-LT at the University Hospital Essen between 11/2003 and 07/2012 and showed a primary graft function.<h4>Results</h4>Of the 374 recipients, 225 (60.16%) had prolonged ICU-stay. On univariate anal ...[more]

PMID: 28319169

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High MELD score and extended operating time predict prolonged initial ICU stay after liver transplantation and influence the outcome.

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High MELD score and extended operating time predict prolonged initial ICU stay after liver transplantation and influence the outcome.

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