Multicentric Study of the Andalusian Experience in Polycystic Liver Disease as Indication for Liver Transplantation

Transplant Proc. 2018 Mar;50(2):613-616. doi: 10.1016/j.transproceed.2017.09.073.

Abstract

Background: The purpose of this study was to determine the morbidity and survival in patients with polycystic liver disease (PLD) undergoing liver transplantation (LT) in 4 Spanish hospitals.

Methods: A multicentric retrospective study using a prospective database was designed including 19 LTs after PLD diagnosis performed from January 1, 1990, to December 31, 2016. Pediatric patients were excluded from the analysis.

Results: Of the included patients, 63.2% were female, the overall average age was 52.16 ± 11.276 years, median time on the waiting list was 394 days (interquartile range [IQR], 96.25-464.50) and most of them were classified with Model for End-Stage Liver Disease scores of ≤17. Eleven patients received isolated LT, 1 patient had a previous kidney transplantation (KT), and 7 patients received combined liver-kidney transplantation, 4 of them with a previous nephrectomy. Complications include hepatopulmonary syndrome in 10.5%, paralytic ileus in 10.5%, transient renal dysfunction in 10.5%, and hepatorenal syndrome in 5.3%. The most common surgical complication was bleeding (15.8%). Three patients presented graft rejection, which was treated by means of immunosuppressive optimization (15.8%), with corticosteroid addition needed in 1 of them. Thrombosis of the hepatic artery occurred in 3 patients, requiring retransplantation in 2 of them. Most of the patients had improved renal function after the procedure. The mortality rate was 15.8%, related to tumors or sepsis, with an estimated 86% 5-year graft survival.

Conclusions: PLD as indication of LT presents a low complications rate and better graft survival and renal function, especially when KT is associated with LT.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cysts / epidemiology*
  • Cysts / surgery*
  • Female
  • Graft Survival
  • Humans
  • Infant
  • Kidney Transplantation
  • Liver Diseases / epidemiology*
  • Liver Diseases / surgery*
  • Liver Transplantation* / adverse effects
  • Liver Transplantation* / methods
  • Male
  • Postoperative Complications / epidemiology
  • Prospective Studies
  • Reoperation
  • Retrospective Studies
  • Spain
  • Waiting Lists

Supplementary concepts

  • Polycystic liver disease