Clin Mol Hepatol.  2021 Jul;27(3):451-462. 10.3350/cmh.2020.0292.

Outcomes after liver transplantation in Korea: Incidence and risk factors from Korean transplantation registry

Affiliations
  • 1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 2Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 3Novartis Korea Ltd., Seoul, Korea
  • 4Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
  • 5Division of Hepato-Biliary-Pancreatic Surgery and liver Transplantation, Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
  • 6Department of Liver Transplantation and Hepatobiliary Surgery, Ajou University School of Medicine, Suwon, Korea
  • 7Department of Surgery, Catholic University of Daegu College of Medicine, Daegu, Korea
  • 8Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 9Division of HBP Surgery & Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea
  • 10Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
  • 11Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
  • 12Department of Surgery, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
  • 13Department of Surgery, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
  • 14Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea
  • 15Department of Surgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
  • 16Department of Surgery, Hanyang University College of Medicine, Seoul, Korea
  • 17Department of Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
  • 18Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

Abstract

Background/Aims
To analyze the incidence and risk factors of outcomes after liver transplantation (LT) in the Korean population.
Methods
This study analyzed data from the liver cohort of Korean Organ Transplantation Registry (KOTRY) who had LT between May 2014 and December 2017. Study measures included the incidence of post-LT outcomes in recipients of living donor LT (LDLT) and deceased donor LT (DDLT). Cox multivariate proportional hazards model was used to determine the potential risk factors predicting the outcomes.
Results
A total of 2,563 adult recipients with LT (LDLT, n=1,956; DDLT, n=607) were included, with mean┬▒standard deviation age of 53.9┬▒8.9 years, and 72.2% were male. The post-LT outcomes observed in each LDLT and DDLT recipients were death (4.0% and 14.7%), graft loss (5.0% and 16.1%), rejection (7.0% and 12.0%), renal failure (2.7% and 13.8%), new onset of diabetes (12.5% and 15.4%), and hepatocellular carcinoma (HCC) recurrence (both 6.7%). In both LDLT and DDLT recipients, the most common post-LT complications were renal dysfunction (33.6% and 51.4%), infection (26.7% and 48.4%), and surgical complication (22.5% and 23.9%). Incidence of these outcomes were generally higher among recipients of DDLT than LDLT. Multivariate analysis indicated recipient age and DDLT as significant risk factors associated with death and graft loss. DDLT and ABO incompatible transplant were prognostic factors for rejection, and HCC beyond Milan criteria at pre-transplant was a strong predictor of HCC recurrence.
Conclusions
This study is a good indicator of the post-LT prognosis in the Korean population and suggests a significant burden of post-LT complications.

Keyword

Liver transplantation; Incidence; Risk factors; Renal insufficiency
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