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Preoperative comorbidity correlates inversely with survival after intestinal and multivisceral transplantation in adults.
File(s)
Author(s)
Sivaprakasam, R
Hidenori, T
Pither, C
Nishida, S
Butler, AJ
Type
Journal Article
Abstract
We investigated the relationship between preoperative comorbidity and postoperative survival after intestinal transplantation. Each patient received a score for preoperative comorbidity. Each comorbidity was given a score based on the degree it impaired function (score range 0-3). A total score was derived from the summation of individual comorbidity scores. Patients (72 adults (M : F, 33 : 39)) received an isolated intestinal graft (27) or a cluster graft (45). Mean (standard deviation) survival was 1501 (1444) days. The Kaplan-Meier analysis revealed a significant inverse association between survival and comorbidity score (logrank test for trend, P < 0.0001). Patients grouped into comorbidity scores of 0 and 1, 2 and 3, 4 and 5, 6, and above had hazard ratios (95% confidence intervals) for death (compared to group 0 + 1), which increased with comorbidity scores: 1.945 (0.7622-5.816), 5.075 (3.314-36.17), and 13.77 (463.3-120100), respectively, (P < 0.0001). Receiver-operator curves at 1, 3, 5, and 10 years postoperative had "C" statistics of 0.88, 0.85, 0.88, and 0.92, respectively. When evaluating patients for transplantation, the degree of comorbidity should be considered as a major factor influencing postoperative survival.
Date Issued
2013-01-31
Date Acceptance
2013-03-05
URI
DOI
ISSN
2090-0007
Start Page
202410
Journal / Book Title
J Transplant
Volume
2013
Copyright Statement
Copyright © 2013 Rajesh Sivaprakasam et al. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/23691271
Publication Status
Published
Coverage Spatial
United States