An analysis of late deaths after liver transplantation

Sami Asfar, Peter Metrakos, Jonathan Fryer, Deborah Verran, Cameron Ghent, David Grant, Michael Bloch, Patsy Burns, William Wall*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

98 Scopus citations

Abstract

Late deaths (after more than 1 year) after liver transplantation were analyzed in a series of 464 consecutive patients who received liver grafts between 1982 and 1993. Recipients who survived the first posttransplant year (n=365) had actuarial 5- and 10-year survival rates of 92% and 84%, respectively. Thirty-five patients died between L1 and 7.6 years after transplantation (mean, 3.2 ± 1.9 years). The most common causes of death were related to immunosuppression (40%), namely, chronic rejection, opportunistic infection, and lymphoma. The second most common causes of death were related to the primary disease for which liver transplantation was performed (34.3%), mainly recurrence of hepatobiliary malignancy and hepatitis B. Eight patients (22.9%) died of unrelated and unpredicted causes, most commonly of cardiovascular disease. Although the survival of liver recipients who live beyond the first posttransplant year is excellent, control of rejection and the consequences of chronic immunosuppression are continual threats. Modification of immunosuppression may help in decreasing the mortality of long-term survivors. In addition, better selection of recipients and effective adjuvant therapies (antiviral and antineoplastic) are needed in patients in whom the primary liver disease is notorious for recurrence.

Original languageEnglish (US)
Pages (from-to)1377-1381
Number of pages5
JournalTransplantation
Volume61
Issue number9
DOIs
StatePublished - May 15 1996

ASJC Scopus subject areas

  • Transplantation

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