Original articlePancreas, biliary tract, and liverKarnofsky Performance Status Following Liver Transplantation in Patients With Multiple Organ Failures and Probable Acute-on-Chronic Liver Failure
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Patients and Methods
We included adult patients (age, >18 y) who received a transplant within 30 days of listing with the United Network for Organ Sharing (UNOS) between January 1, 2006, and September 30, 2016. The start date of January 1, 2006, was selected because KPS scores were collected consistently since 2006. Among these patients, we determined the prevalence of OF using a modified version of the Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) scale.16 The organ failure types included
Results
During the study period, KPS scores of 7124 patients who received a transplant within 30 days of listing were available for the analysis. Of those, 2838 had no OF, 1587 had 1 OF, 1357 had 2 OFs, 731 had 3 OFs, 365 had 4 OFs, and 246 had 5 to 6 OFs. Patients who had LT in the presence of multiple OFs were relatively younger compared with those without OF (Table 1). The mean MELD scores were lower (16.5 ± 5.8) in patients without OF compared with patients with 1 to 6 OFs (Table 1). In patients
Discussion
This retrospective cohort analysis showed that the majority of patients (60%–67%) with 3 or more OFs achieved excellent performance status (KPS score, >80) after LT compared with 74% in patients without OFs. Our findings are very reassuring considering that many of these patients had 3 or more organ failures and were in the intensive care unit (ICU) at the time of LT. More importantly, all 246 patients with 5 to 6 OFs were on circulatory support and 227 (92.3%) were on ventilatory support,
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Conflicts of interest The authors disclose no conflicts.