The survival rate after liver transplantation has greatly improved. However, complications such as infection and rejection remain major causes of mortality and morbidity. The fungal infections are associated with high mortality rates, despite having a relatively lower incidence, compared with bacterial and viral infections. Difficulty in establishing an early diagnosis, lack of effective therapy, difficult management of certain antifungal agent, limited data for antifungal prophylaxis presents remaining problems.3) We report our experience with one case of syatemic candidemia after orthotopic liver transplantation.
Candidemia* ; Early Diagnosis ; Incidence ; Liver Transplantation* ; Liver* ; Mortality ; Survival Rate

The survival rate after liver transplantation has greatly improved. However, complications such as infection and rejection remain major causes of mortality and morbidity. The fungal infections are associated with high mortality rates, despite having a relatively lower incidence, compared with bacterial and viral infections. Difficulty in establishing an early diagnosis, lack of effective therapy, difficult management of certain antifungal agent, limited data for antifungal prophylaxis presents remaining problems.3) We report our experience with one case of syatemic candidemia after orthotopic liver transplantation.
Candidemia* ; Early Diagnosis ; Incidence ; Liver Transplantation* ; Liver* ; Mortality ; Survival Rate

BACKGROUND: The timing of tracheal extubation in patients undergoing major intraoperative procedures is controversial. Immediate postoperative tracheal extubation after liver transplantation was not popularized. But in these days, early tracheal extubation has been safely performed in certain cases and routine use of mechanical ventilation is being questioned. We performed preliminary study of our 25 liver transplantation cases to evaluate factors affecting duration and indications of postoperative mechanical ventilation. METHODS: Our 25 cases were divided into two groups by periodic difference - early 13 cases (group 1) and late 12 cases (group 2). We evaluated preoperative UNOS (united network for organ sharing) scale, intraoperative transfusion and vasopressor requirement, postoperative multiple organ complications which would have influence upon tracheal extubation. RESULTS: We found great difference between two groups in duration of mechanical ventilation (Group 1: 94.4+/-7.12 hrs, Group 2: 36.1+/-28.3 hrs) and ICU stay (Group 1: 22.8+/-8.3 days, Group 2: 11.8+/-5.5 days). CONCLUSIONS: We concluded that early tracheal extubation in selected liver transplantation cases was safe and effective because it could shorten duration of ICU stay and reduce postoperative mortality. But more experience and knowledge may be needed to get more ideal guidelines for postoperative mechanical ventilation.
Airway Extubation* ; Humans ; Liver Transplantation* ; Liver* ; Mortality ; Respiration, Artificial

Humans ; Liver Failure ; mortality ; surgery ; Liver Transplantation ; mortality ; Models, Biological ; Prognosis ; Risk Factors ; Survival Rate

China ; Humans ; Liver Transplantation ; methods ; mortality ; trends ; Survival Rate ; trends

BACKGROUNDThere are increasing numbers of patients who survive more than one year after liver transplantation. Many studies have focused on the early mortality of these patients. However, the factors affecting long-term survival are not fully understood. This study aims to evaluate prognostic factors predicting long-term survival and to explore measures for improving the survival outcomes of patients who underwent liver transplantation for benign end-stage liver diseases.

METHODSThe causes of late death after liver transplantation and potential prognostic factors were retrospectively analyzed for 221 consecutive patients who underwent liver transplantation from October 2003 to June 2008. Twenty-seven variables were assessed using the Kaplan-Meier method, and those variables found to be univariately significant at P < 0.10 were entered into a backward step-down Cox proportional hazard regression analysis to identify the independent prognostic factors influencing the recipients' long-term survival.

RESULTSTwenty-eight recipients died one year after liver transplantation. The major causes of late mortality were infectious complications, biliary complications, and Hepatitis B virus recurrence/reinfection. After Cox analysis, the five remaining co-variables were: age, ABO blood group, cold ischemia time, post-infection region, and biliary complications.

CONCLUSIONSThe major causes of late mortality were infection, biliary complications and Hepatitis B virus recurrence/reinfection. Five variables (Age, ABO blood group, cold ischemia time, infection, and biliary complications) had significant impacts on patient survival.

End Stage Liver Disease ; mortality ; surgery ; Hepatitis B ; mortality ; Humans ; Liver Transplantation ; Postoperative Complications ; mortality ; Retrospective Studies

Since the hepatocellular carcinoma (HCC) develops in cirrhotic liver and is often multicentric, liver transplantation (LT) seems to be a rational approach for the treatment of HCC. Current selection criteria of LT for HCC are Milan criteria (single nodule < or = 5 cm , or < or = 3 nodules and Carcinoma, Hepatocellular/etiology/*mortality/*surgery ; Humans ; Liver Cirrhosis/*complications ; Liver Neoplasms/etiology/*mortality/*surgery ; *Liver Transplantation ; Salvage Therapy ; Survival Rate

In patients with detectable virus at the time of liver transplantation, hepatitis C virus (HCV) infection always recurs on the graft, and 30% of patients have an aggressive clinical and histologic course with increased morbidity, mortality, and graft loss. Moreover, in some transplantation patients, recurrent HCV infection leads to an aggressive course of disease known as fibrosing cholestatic hepatitis, which is characterized by hepatic decompensation and death. Liver allograft and recipient survival can be substantially improved with successful eradication of HCV. Recent advances in direct-acting antiviral agents have revolutionized the management of HCV infection, and a number of these agents have shown high sustained virological responses, shorter durations of treatment, and much improved tolerability when compared with previous pegylated interferon based therapies in liver transplant settings.
Allografts ; Antiviral Agents ; Hepacivirus ; Hepatitis C* ; Hepatitis* ; Humans ; Interferons ; Liver Transplantation ; Liver* ; Mortality ; Transplants

Animals ; Humans ; Liver Failure, Acute ; surgery ; Liver Transplantation ; methods ; mortality ; physiology ; Living Donors

Neurological complications following liver transplantation are more common than after other organ transplants. These complications include seizure in about 8% of cases, which is associated with morbidity and mortality. Seizure should be treated immediately, and the process of differential diagnosis has to be performed appropriately in order to avoid permanent neurologic deficit. We herein report a case of status epilepticus after liver transplantation. The status epilepticus was treated promptly and the cause of seizure was assessed. The patient was discharged without any complication.
Diagnosis, Differential ; Humans ; Liver Transplantation* ; Liver* ; Mortality ; Neurologic Manifestations ; Posterior Leukoencephalopathy Syndrome ; Seizures ; Status Epilepticus* ; Transplants