Dear Editor: As in many areas in medicine, database mining is in vogue in transplant hepatology. Large datasets, such as that of the United Network for Organ Sharing (UNOS), have indeed generated many high impact outcome studies that have advanced the specialty on several fronts, particularly concerning our understanding of recipient mortality. Mortality of the recipient is indeed the single most important clinical outcome when assessing the safety, efficacy, and cost-effectiveness of liver transplant surgery. UNOS and similar databases provide a wealth of knowledge on overall recipient mortality, and enable multivariable analyses of clinico-demographic variables in both donors and recipients to identify risk- or protective factors for recipient mortality. Unfortunately, long-term (>3 years) recipient survival has not had the impressive incremental improvements which we have witnessed in short-term recipient survival. Furthermore, outcome studies in liver transplantation have failed to translate into any meaningful improvement in long-term recipient survival. The questions then become: Have longterm recipient survival rates after liver transplantation reached their plateau, or is there room to improve further? And can the study of specific causes of death, rather than all-cause mortality, provide clinical insight and improve patient outcomes?
2012-04-19 | 562 visitas | Evalua este artículo 0 valoraciones
Vol. 11 Núm.3. Mayo-Junio 2012 Pags. 415-417 Ann Hepatol 2012; 11(3)