Date: Monday, May 1, 2017
Session Time: 2:30pm-4:00pm
Presentation Time: 3:18pm-3:30pm
Purpose: The overall 1- and 3- year graft survival rates following liver transplant are 89.1% and 79.9%, respectively. While these numbers have vastly improved, they remain suboptimal and it is unclear if the etiologies of graft loss have changed over time.
Methods: This was a retrospective, longitudinal, case-control study conducted at an academic medical center which included patients who received a solitary liver transplant from Jan 1, 2010 to Dec 31, 2015. Pediatric recipients, multi-organ recipients, and graft losses/death in the first 30 days were excluded. The primary outcome was to identify changes in cause of graft loss (GL) over time. The secondary outcome was to identify risk factors for early graft loss (EGL) versus late graft loss (LGL). EGL was defined as GL between days 31 and 365, while LGL was defined as GL after day 365.
Results: A total of 296 patients were identified and included in the analysis. The risk of GL from a cardiovascular cause increased by 15.9% per year (p=0.045) between 2010 and 2015. The risk of GL decreased by 7.6% per year from infection/malignancy (p=0.034), 4.5% per year from liver failure/rejection (p=0.431), and 3.7% per year from other/unknown causes (p=0.007). Patients who received a split liver, received IL2RA induction, required renal replacement therapy during their hospitalization, had 1 or more acute rejection episodes, had 1 or more readmission within 30 days, and had shorter time to hepatitis C recurrence were at higher risk for graft loss.
Conclusions: Causes of GL changed from 2010 to 2015 with a significant increase due to cardiovascular causes and a decrease due to infection/malignancy. Several factors significantly increased the risk of overall GL; however, few factors increased the risk of EGL versus LGL.
CITATION INFORMATION: Sell M, Mardis A, Lee I, O'Brien B, Perez C, Rogers A, Mardis C, Patel N, Fleming J, Meadows H, Pilch N, Chavin K, Taber D. Cardiovascular Events Are a Substantial and Increasing Cause of Graft Loss in Liver Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Sell M, Mardis A, Lee I, O'Brien B, Perez C, Rogers A, Mardis C, Patel N, Fleming J, Meadows H, Pilch N, Chavin K, Taber D. Cardiovascular Events Are a Substantial and Increasing Cause of Graft Loss in Liver Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). http://atcmeetingabstracts.com/abstract/cardiovascular-events-are-a-substantial-and-increasing-cause-of-graft-loss-in-liver-transplant-recipients/. Accessed November 18, 2017.
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