Refractory ascites after liver transplantation

An analysis of 1058 liver transplant patients at a single center

Seigo Nishida, Jeffrey Gaynor, N. Nakamura, F. Butt, H. G. Illanes, J. Kadono, G. W. Neff, D. M. Levi, J. I. Moon, Gennaro Selvaggi, T. Kato, Phillip Ruiz, A. G. Tzakis, J. R. Madariaga

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

A retrospective study of 1058 liver transplant recipients was performed to determine: (i) the incidence, etiology, timing, clinical features and treatment of refractory ascites (RA), (ii) risk factors for RA development, (iii) predictors of RA disappearance, (iv) predictors of survival following RA and (v) the impact of RA on patient survival. Sixty-two patients (5.9%) developed RA and its disappearance occurred in 27/62 cases. Patients having hepatitis C virus (HCV) had a significantly higher hazard rate of developing RA (p < 0.00001). No other baseline characteristic was associated with RA. Cox stepwise regression analysis of the hazard rate of RA disappearance found two significant factors: HCV recurrence as the reason for developing RA implied a poorer outcome (p = 0.006), whereas an unknown reason implied a favorable outcome (p = 0.02). In addition, survival following RA was significantly poorer among patients having bacterial peritonitis or HCV recurrence. Finally, the mortality rate was significantly (nearly 8.6 times) higher in patients following RA development while it was ongoing (p < 0.00001); however, if the RA disappeared, then the additional risk of death also disappeared. This study illustrates the importance of developing an optimal treatment strategy to (i) effectively treat RA if it develops and (ii) prevent hepatitis C recurrence.

Original languageEnglish
Pages (from-to)140-149
Number of pages10
JournalAmerican Journal of Transplantation
Volume6
Issue number1
DOIs
StatePublished - Jan 1 2006

Fingerprint

Ascites
Liver Transplantation
Transplants
Liver
Hepacivirus
Recurrence
Survival
Hepatitis C
Peritonitis
Retrospective Studies
Regression Analysis

Keywords

  • Complication
  • Hepatitis C
  • Liver transplant
  • Refractory ascites

ASJC Scopus subject areas

  • Immunology

Cite this

Refractory ascites after liver transplantation : An analysis of 1058 liver transplant patients at a single center. / Nishida, Seigo; Gaynor, Jeffrey; Nakamura, N.; Butt, F.; Illanes, H. G.; Kadono, J.; Neff, G. W.; Levi, D. M.; Moon, J. I.; Selvaggi, Gennaro; Kato, T.; Ruiz, Phillip; Tzakis, A. G.; Madariaga, J. R.

In: American Journal of Transplantation, Vol. 6, No. 1, 01.01.2006, p. 140-149.

Research output: Contribution to journalArticle

Nishida, S, Gaynor, J, Nakamura, N, Butt, F, Illanes, HG, Kadono, J, Neff, GW, Levi, DM, Moon, JI, Selvaggi, G, Kato, T, Ruiz, P, Tzakis, AG & Madariaga, JR 2006, 'Refractory ascites after liver transplantation: An analysis of 1058 liver transplant patients at a single center', American Journal of Transplantation, vol. 6, no. 1, pp. 140-149. https://doi.org/10.1111/j.1600-6143.2005.01161.x
Nishida, Seigo ; Gaynor, Jeffrey ; Nakamura, N. ; Butt, F. ; Illanes, H. G. ; Kadono, J. ; Neff, G. W. ; Levi, D. M. ; Moon, J. I. ; Selvaggi, Gennaro ; Kato, T. ; Ruiz, Phillip ; Tzakis, A. G. ; Madariaga, J. R. / Refractory ascites after liver transplantation : An analysis of 1058 liver transplant patients at a single center. In: American Journal of Transplantation. 2006 ; Vol. 6, No. 1. pp. 140-149.
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