Published online Aug 27, 2020. doi: 10.4240/wjgs.v12.i8.336
Peer-review started: February 29, 2020
First decision: May 24, 2020
Revised: June 12, 2020
Accepted: August 1, 2020
Article in press: August 1, 2020
Published online: August 27, 2020
In surgical procedures such as gastrectomy, esophagectomy or resection of liver metastases, postoperative complications are associated with poorer long-term survival. It is possible this happens in liver transplant (LT) but there are not enough data to establish this relationship.
To define whether long-term prognosis is influenced by postoperative complications after LT.
To analyze the possible influence of postoperative complications on long-term survival and the ability of the comprehensive complication index (CCI) to predict this.
Retrospective study of 164 LT patients. The medical records concerning postoperative complications and long-term survival were analyzed. Univariate and multivariable tests were performed for statistical analysis.
A ROC curve of CCI with 5-year survival was built. Survival curves for comparison of patients with CCI cut-off values of 36 and 33.5 showed significant statistical differences, suggesting that patients with more severe complications exhibit worse long-term survival. A multivariate analysis was carried out to analyze the possible influence of CCI, Charlson comorbidity index, BAR and hepatocellular carcinoma on survival. Only the CCI score showed significant influence on long-term survival.
A complicated postoperative period – well-defined by means of the CCI score – can influence not only short-term survival, but also long-term survival of LT patients.
Refinement and surgical technique and postoperative care are mandatory to improve short-term result but this also influence long-term survival.