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Early post‐liver transplant surgical morbidity in HIV‐infected recipients: risk factor for overall survival? A nationwide retrospective study

Baccarani, Umberto ; Pravisani, Riccardo ; Isola, Miriam ; Mocchegiani, Federico ; Lauterio, Andrea ; Righi, Elda ; Magistri, Paolo ; Corno, Vittorio ; Adani, Gian Luigi ; Lorenzin, Dario ; Di Sandro, Stefano ; Pagano, Duilio ; Bassetti, Matteo ; Gruttadauria, Salvatore ; Colledan, Michele ; De Carlis, Luciano ; Vivarelli, Marco ; Di Benedetto, Fabrizio ; Risaliti, Andrea

Transplant International, October 2019, Vol.32(10), pp.1044-1052 [Rivista Peer Reviewed]

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  • Titolo:
    Early post‐liver transplant surgical morbidity in HIV‐infected recipients: risk factor for overall survival? A nationwide retrospective study
  • Autore: Baccarani, Umberto ; Pravisani, Riccardo ; Isola, Miriam ; Mocchegiani, Federico ; Lauterio, Andrea ; Righi, Elda ; Magistri, Paolo ; Corno, Vittorio ; Adani, Gian Luigi ; Lorenzin, Dario ; Di Sandro, Stefano ; Pagano, Duilio ; Bassetti, Matteo ; Gruttadauria, Salvatore ; Colledan, Michele ; De Carlis, Luciano ; Vivarelli, Marco ; Di Benedetto, Fabrizio ; Risaliti, Andrea
  • Note di contenuto: The aim of the study was to analyse the risk factors for early surgical complications requiring relaparotomy and the related impact on overall survival () in ‐infected patients submitted to liver transplantation. Thus a retrospective investigation was conducted on a nationwide multicentre cohort of 157 patients submitted to liver transplantation in six Italian Transplant Units between 2004 and 2014. An early relaparotomy was performed in 24.8% of cases and the underlying clinical causes were biliary leak (8.2%), bleeding (8.2%), intestinal perforation (4.5%) and suspect of vascular complications(3.8%). No differences in terms of prevalence for either overall or cause‐specific early relaparotomies were noted when compared with a non‐ control group, matched for , recipient age, ‐ positivity and prevalence. While in the control group an early relaparotomy appeared a negative prognostic factor, such impact on was not noted in recipients. Nonetheless increasing number of relaparotomies were associated with decreased survival. In multivariate analysis, preoperative refractory ascites and Roux‐en‐Y choledochojejunostomy reconstruction were significant risk factors for early relaparotomy. To conclude, in liver transplanted patients, an increasing number of early relaparotomies because of surgical complications does negatively affect the . Preoperative refractory ascites reflecting a severe portal hypertension and a difficult biliary tract reconstruction requiring a Roux‐en‐Y choledochojejunostomy are associated with increased risk of early relaparotomy.
  • Fa parte di: Transplant International, October 2019, Vol.32(10), pp.1044-1052
  • Soggetti: Complications ; Human Immunodeficiency Virus ; Liver Transplantation ; Relaparotomy
  • Tipo: Articolo
  • Identificativo: ISSN: 0934-0874 ; E-ISSN: 1432-2277 ; DOI: 10.1111/tri.13446
  • Fonte: John Wiley & Sons, Inc.

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