Predictors of worse graft survival:
(1) decreased renal function (calculated creatinine clearance < 90 mL/min per 1.73 m sq)
(2) prolonged warm ischemia time (> 60 minutes)
Predictors of worse patient survival:
(1) decreased renal function
(2) pretransplant dependency on mechanical ventilation
(3) type of underlying liver disease
Types of liver disease associated with poor patient survival:
(1) retransplantation
(2) autoimmune liver disease
(3) parenteral nutrition associated liver disease
(4) tumor
(5) neonatal hepatitis
where:
• Creatinine clearance was estimated using the equations of Schwartz et al (see Chapter 14, 14.02.07). The estimates are in mg/dL per 1.73 square meters BSA.
• Cholestatic liver disease was used as the reference disease for comparing survival with other liver diseases.
Interpretation:
• The graft survival at 10 years with no graft-related risk factors was 80% (about 10% show early graft loss).
• The graft survival at 10 years with 1 or 2 graft-related risk factors was about 60%.(about 25% show early graft loss).
• The 10 year survival for a patient with no risk factors is about 95%.
• The 10 year survival for a patient with 1 or 2 risk factors is about 75%.
• The 10 year survival for a patient with 3 risk factors is 50%. Most of the mortality occurs within the first 3 months after the transplant.
