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Germani G, Zeni N, Zanetto A, Adam R, Karam V, Belli LS, O'Grady J, Mirza D, Klempnauer J, Cherqui D, Pratschke J, Jamieson N, Salizzoni M, Hidalgo E, Lerut J, Paul A, Garcia-Valdecasas JC, Rodríguez FSJ, Villa E, Burra P. Influence of donor and recipient gender on liver transplantation outcomes in Europe. Liver Int 2020; 40:1961-1971. [PMID: 32418358 DOI: 10.1111/liv.14510] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/21/2020] [Accepted: 05/06/2020] [Indexed: 02/13/2023]
Abstract
BACKGROUND & AIMS The impact of gender and donor/recipient gender mismatch on LT outcomes is controversial. The aim of this study was to compare outcomes of LT in Europe, using the ELTR database, between male and female recipients, including donor/recipient gender mismatch. METHODS Recipient, donor and transplant characteristics were compared between male and female patients. Patient survival was compared between groups, and the impact of donor/recipient gender matching as well as donor and recipient anthropometric characteristics were evaluated as potential risk factors for post-LT death/graft loss. RESULTS A total of 46,334 LT patients were evaluated (70.5% men and 29.5% women). Ten-year survival rate was significantly higher in female than in male recipients (66% vs 59%, P < .0001). At multivariate analysis, adjusted for indication to LT and type of graft, donor/recipient gender mismatch (HR 1.12, 95% CI 1.04-1.2; P = .003), donor age > 60 years (HR 1.09, 95% CI 1.01-1.18; P = .027) and recipient age (HR 1.02, 95% CI 1.1-1.02; P < .0001) were significantly associated with post-LT lower survival rate in men. Conversely in female recipients, donor BMI > 30 (HR 1.32, 95% CI 1.09-1.6; P = .005), donor age > 60 years (HR 1.15, 95% CI 1.01-1.32; P = .027) and recipient age (HR 1.02, 95% CI 1.01-1.02; P < .0001) were significantly associated with lower post-LT survival rate. CONCLUSIONS Donor/recipient gender mismatch in male recipients and the use of obese donor in female recipients are associated with reduced survival after LT. Therefore, the incorporation of donor and recipient anthropometric quantities in the allocation process should be a matter of further studies, as their matching can significantly influence long-term outcomes.
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Affiliation(s)
- Giacomo Germani
- Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
| | - Nicola Zeni
- Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
| | - Alberto Zanetto
- Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
| | - René Adam
- ELTR, Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, Centre Hepato-Biliaire, Universite´Paris-Sud, Villejuif, France
| | - Vincent Karam
- ELTR, Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, Centre Hepato-Biliaire, Universite´Paris-Sud, Villejuif, France
| | - Luca S Belli
- Gastroenterology and Hepatology, Liver Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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- Universitè Catholique Louvain, Brussels, Belgium
| | | | | | | | - Erica Villa
- Department of Gastroenterology, Policlinico of Modena University Hospital of Modena, Modena, Italy
| | - Patrizia Burra
- Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
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Adam R, Karam V, Delvart V, O'Grady J, Mirza D, Klempnauer J, Castaing D, Neuhaus P, Jamieson N, Salizzoni M, Pollard S, Lerut J, Paul A, Garcia-Valdecasas JC, Rodríguez FSJ, Burroughs A. Evolution of indications and results of liver transplantation in Europe. A report from the European Liver Transplant Registry (ELTR). J Hepatol 2012. [PMID: 22609307 DOI: 10.1016/j.jhep.2012.04.015]available] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- René Adam
- Paul Brousse Hospital, Villejuif, France.
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Adam R, Karam V, Delvart V, O'Grady J, Mirza D, Klempnauer J, Castaing D, Neuhaus P, Jamieson N, Salizzoni M, Pollard S, Lerut J, Paul A, Garcia-Valdecasas JC, Rodríguez FSJ, Burroughs A. Evolution of indications and results of liver transplantation in Europe. A report from the European Liver Transplant Registry (ELTR). J Hepatol 2012; 57:675-88. [PMID: 22609307 DOI: 10.1016/j.jhep.2012.04.015] [Citation(s) in RCA: 590] [Impact Index Per Article: 49.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Revised: 04/04/2012] [Accepted: 04/05/2012] [Indexed: 12/11/2022]
Affiliation(s)
- René Adam
- Paul Brousse Hospital, Villejuif, France.
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Andújar RL, Orón EM, Herraiz AM, Cano CR, Rodríguez FSJ, Ibars EP, Burgueño MDJ, Castellanos FO, Pallardó JM. Reflexiones sobre 250 intervenciones de metástasis hepáticas de carcinoma colorrectal. Cir Esp 2007; 81:269-75. [PMID: 17498456 DOI: 10.1016/s0009-739x(07)71317-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The best results in the treatment of colorectal cancer metastases to the liver are currently achieved with surgical resection performed under high quality standards. OBJECTIVES. To analyze the results and quality standards of the surgical treatment of colorectal cancer liver metastases in a referral liver unit over an 11-year period. PATIENTS AND METHOD From January 1995 to December 2005, 250 surgical interventions were performed in 221 patients diagnosed with colorectal cancer liver metastases, resulting in 201 hepatic resections. RESULTS Nineteen percent of patients were >/= 70 years old and comorbidity was present in 54%. Of the 201 hepatic resections, 8.5% were second resections. Major hepatectomy was performed in 39% of the patients. R0 resection was achieved in 85% of the patients. Blood transfusions were not required in 80% of the patients. The median length of postoperative stay was 6 days. Postoperative mortality was nil and morbidity was 19%. Morbidity was associated with the number of resected segments and the need for blood transfusion. The estimated 1-, 3- and 5-year cumulative survival rates were 96%, 69% and 52%, respectively, while estimated disease-free survival rates were 58%, 32% and 24%, respectively. CONCLUSIONS Resection of colorectal cancer liver metastases is an effective therapeutic alternative if high current quality standards are achieved.
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Affiliation(s)
- Rafael López Andújar
- Unidad de Cirugía y Trasplante Hepatobiliopancreático, Hospital Universitario La Fe, Valencia, España.
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