Hospitalization Before Liver Transplantation Predicts Posttransplant Patient Survival: A Propensity Score–Matched Analysis. Issue 5 (21st April 2020) - Wiering, Leke
Abstract : In contrast to donor factors predicting outcomes of liver transplantation (LT), few suitable recipient parameters have been identified. To this end, we performed an in‐depth analysis of hospitalization status and duration prior to LT as a potential risk factor for posttransplant outcome. The pretransplant hospitalization status of all patients undergoing LT between 2005 and 2016 at the Charité‐Universitätsmedizin Berlin was analyzed retrospectively using propensity score matching. At the time of organ acceptance, 226 of 1134 (19.9%) recipients were hospitalized in an intensive care unit (ICU), 146 (12.9%) in a regular ward (RW) and 762 patients (67.2%) were at home. Hospitalized patients (RW and ICU) compared with patients from home showed a dramatically shorter 3‐month survival (78.7% versus 94.4%), 1‐year survival (66.3% versus 87.3%), and 3‐year survival (61.7% versus 81.7%; all P < 0.001), whereas no significant difference was detected for 3‐year survival between ICU and RW patients (61.5% versus 62.3%; P = 0.60). These results remained significant after propensity score matching. Furthermore, in ICU patients, but not in RW patients, survival correlated with days spent in the ICU before LT (1‐year survival: 1‐6 versus 7‐14 days: 73.7% versus 60.5%, P = 0.04; 7‐14 days versus >14 days, 60.5% versus 51.0%, P = 0.006). In conclusion, hospitalization status before transplantation is a valuable predictor of patient survival following LT.