Impact of Previous Hepatic Resection on the Outcome of Liver Transplantation: A Case-Control Analysis
University of Bologna, Bologna, Italy
Meeting: 2019 American Transplant Congress
Abstract number: D381
Keywords: Hepatocellular carcinoma, Liver transplantation, Outcome, Surgical complications
Session Information
Session Name: Poster Session D: Late Breaking
Session Type: Poster Session
Date: Tuesday, June 4, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: The aim of this study was to investigate the impact of HR on the outcome of LT.
*Methods: Data of patients treated by LT between 2005 and 2018 were analyzed. Patients submitted to LT with previous hepatic resection (HR-LT) were selected as the study group (case), whereas patients undergoing LT without previous abdominal surgery (NHR-LT) were selected as the control group. Patients with any other abdominal surgery (including re-LT), with acute liver failure, receiving graft from DCD, partial graft implantation, domino or combined transplants were excluded. To reduce the influence of possible confounding variables, the two groups were compared after the implementation of a 1:1 matching based on the presence of HCC (yes/no), MELD score (≤20/>20), BAR score (≤9/>9), and HCV infection (yes/no). Recently reported benchmark cutoffs values for LT were used to define high-risk sub-groups. Primary endpoints of the study were short-term outcomes as major morbidity, high Comprehensive Complication Index (CCI > 29.6) and 90-day mortality.
*Results: During the study period, 1133 patients were submitted to LT. Among them, 94 patients underwent previous HR. According to the inclusion criteria, 82 patients were considered (HR-LT). HCC represented the primary indication for HR (91.5%) and major resection was performed in 6% of patients. Minimally invasive HR was performed in 11% of cases. In the same period, 349 patients underwent LT without previous abdominal surgery (NHR-LT) and 132 out of 349 (40.1%) for HCC. According to the study design, 82 HR-LT were matched with 82 NHR-LT. Operative time (P=0.479), intraoperative blood transfusions (P=0.470), and hospital stay (P=0.970) were comparable between HR-LT and NHR-LT. There were no difference in terms of major morbidity (29.3% vs 28%, P=0.863), high CCI (29.3% vs 29.1%, P=0.983) or 90-day mortality (0% vs 1.2%, P=0.316). The overall 1- and 5-year survival did not differ between the 2 groups (P=0.381 and P=0.841, respectively).
*Conclusions: Liver transplantation is feasible and safe in case of previous HR. Complications rate and 90-day mortality are in line with the benchmark values reported for LT. The advantage of a laparoscopic approach on the outcome of LT needs to be further evaluated.
To cite this abstract in AMA style:
Serenari M, Paterno M, Pinna AD, Ravaioli M, Prosperi E, Gaudio MDel, Zanfi C, Bertuzzo V, Frascaroli G, Cescon M. Impact of Previous Hepatic Resection on the Outcome of Liver Transplantation: A Case-Control Analysis [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-previous-hepatic-resection-on-the-outcome-of-liver-transplantation-a-case-control-analysis/. Accessed May 8, 2025.« Back to 2019 American Transplant Congress