Castanedo S, Toledo E, Fernández-Santiago R, Castillo F, Echeverri J, Rodríguez-Sanjuán JC. Influence of postoperative complications on long-term survival in liver transplant patients. World J Gastrointest Surg 2020; 12(8): 336-345 [PMID: 32903918 DOI: 10.4240/wjgs.v12.i8.336]
Corresponding Author of This Article
Juan Carlos Rodríguez-Sanjuán, MD, PhD, Professor, Department of General Surgery, University Hospital Marqués de Valdecilla, University of Cantabria, Avenida de Valdecilla S/N, Santander 39008, Spain. juancarlos.rodriguezs@scsalud.es
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2020; 12(8): 336-345 Published online Aug 27, 2020. doi: 10.4240/wjgs.v12.i8.336
Influence of postoperative complications on long-term survival in liver transplant patients
Sonia Castanedo, Enrique Toledo, Roberto Fernández-Santiago, Federico Castillo, Juan Echeverri, Juan Carlos Rodríguez-Sanjuán
Sonia Castanedo, Enrique Toledo, Roberto Fernández-Santiago, Federico Castillo, Juan Echeverri, Juan Carlos Rodríguez-Sanjuán, Department of General Surgery, University Hospital Marqués de Valdecilla, University of Cantabria, Santander 39008, Spain
Author contributions: Rodríguez-Sanjuán JC, Fernández-Santiago R and Castillo F designed the research study; Castanedo S, Toledo E and Echeverri J acquired and analyzed the data; Rodríguez-Sanjuán JC, Castanedo S and Toledo E wrote the manuscript; all authors have read and approve the final manuscript.
Institutional review board statement: The manuscript was approved by University Hospital Marqués de Valdecilla Ethical Committee.
Informed consent statement: Consent was not obtained but the presented data are anonymized and risk of identification is low.
Conflict-of-interest statement: The authors declare no conflict of interests.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at juancarlos.rodriguezs@scsalud.es.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Juan Carlos Rodríguez-Sanjuán, MD, PhD, Professor, Department of General Surgery, University Hospital Marqués de Valdecilla, University of Cantabria, Avenida de Valdecilla S/N, Santander 39008, Spain. juancarlos.rodriguezs@scsalud.es
Received: March 5, 2020 Peer-review started: February 29, 2020 First decision: May 24, 2020 Revised: June 12, 2020 Accepted: August 1, 2020 Article in press: August 1, 2020 Published online: August 27, 2020 Processing time: 168 Days and 17.4 Hours
ARTICLE HIGHLIGHTS
Research background
In surgical procedures such as gastrectomy, esophagectomy or resection of liver metastases, postoperative complications are associated with poorer long-term survival. It is possible this happens in liver transplant (LT) but there are not enough data to establish this relationship.
Research motivation
To define whether long-term prognosis is influenced by postoperative complications after LT.
Research objectives
To analyze the possible influence of postoperative complications on long-term survival and the ability of the comprehensive complication index (CCI) to predict this.
Research methods
Retrospective study of 164 LT patients. The medical records concerning postoperative complications and long-term survival were analyzed. Univariate and multivariable tests were performed for statistical analysis.
Research results
A ROC curve of CCI with 5-year survival was built. Survival curves for comparison of patients with CCI cut-off values of 36 and 33.5 showed significant statistical differences, suggesting that patients with more severe complications exhibit worse long-term survival. A multivariate analysis was carried out to analyze the possible influence of CCI, Charlson comorbidity index, BAR and hepatocellular carcinoma on survival. Only the CCI score showed significant influence on long-term survival.
Research conclusions
A complicated postoperative period – well-defined by means of the CCI score – can influence not only short-term survival, but also long-term survival of LT patients.
Research perspectives
Refinement and surgical technique and postoperative care are mandatory to improve short-term result but this also influence long-term survival.
