03 November 2020 : Original article
Comorbidity Burden May Be Associated with Increased Mortality in Patients with Severe Acute Liver Injury Referred for Liver Transplantation
Lindsey Steiner-Temnykh1ABCDEF, Lara Dakhoul2ABCDEF, James Slaven3ACDE, Lauren Nephew2BCDEF, Kavish R. Patidar2BCDEF, Eric Orman2BCDEF, Archita P. Desai2BCDEF, Eduardo Vilar-Gomez2BCDEF, Chandrashekhar Kubal4BCDEF, Burcin Ekser4BCDEF, Naga Chalasani2ABCDEF, Marwan Ghabril2ABCDEF*DOI: 10.12659/AOT.926453
Ann Transplant 2020; 25:e926453
Table 4 Evaluation and contraindications for liver transplant candidacy in patients surviving vs. dying or undergoing liver transplantation within 30 days after acute liver injury. Data are shown as number (percentage).
| OverallN=136 | Hospitalization or 30-day survivorn=76 | Died or transplant within 30 daysn=60 | P-value | |
|---|---|---|---|---|
| Denied/not candidates | 56 (41) | 36 (47) | 20 (33) | <0.001 |
| Died before completing evaluation or listing | 10 (7) | None | 10 (17) | |
| Improved | 35 (26) | 33 (43) | 2 (3) | |
| Listed | 35 (26) | 7 (9) | 28 (47) | |
| Contraindications for liver transplantation n (%)* | ||||
| Substance abuse | 35 (26) | 25 (33) | 10 (17) | 0.03 |
| Psychiatric disease | 23 (17) | 18 (24) | 5 (8) | 0.02 |
| Poor compliance | 7 (5) | 5 (7) | 2 (3) | 0.4 |
| Inadequate social support | 6 (4) | 4 (5) | 2 (3) | 0.6 |
| Malignancy | 4 (3) | 1 (1) | 3 (5) | 0.2 |
| Cardiac | 3 (2) | 1 (1) | 2 (3) | 0.4 |
| Too sick to be listed | 5 (4) | None | 5 (8) | 0.01 |
| Lack of insurance | 1 (1) | None | 1 (2) | 0.3 |
| Comorbidity impacted candidacy in course of evaluation n (%) | 9 (7) | 2 (3) | 7 (12) | 0.04 |
| None | 75 (55) | 38 (50) | 37 (62) | 0.4 |
| 1 | 40 (29) | 24 (32) | 16 (27) | |
| 2 | 19 (14) | 12 (16) | 7 (12) | |
| 3 | 2 (2) | 2 (3) | None | |
| N=35 | n=7 | n=28 | <0.001 | |
| Died | 8 (23) | 1 (14)** | 7 (25) | |
| Improved | 4 (11) | 4 (57) | None | |
| Transplanted | 23 (66) | 2 (29)** | 21 (75) | |
| * Patients could have multiple contraindications; ** Death or liver transplant more than 30 days after presentation | ||||