Cumulative postoperative change in serum albumin levels and organ failure after living-donor liver transplantation: A retrospective cohort analysis.

Many studies have reported that hypoalbuminemia could be associated with organ failure after liver transplantation. However, most of them focused on serum albumin levels measured at specific time points and not on the trend of serum albumin change. We investigated whether a cumulative postoperative...

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Main Authors: Yoonjee Cho, Ja Eun Lee, Heejoon Jeong, Ji-Hye Kwon, Yu Jeong Bang, Gaabsoo Kim
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0285734
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author Yoonjee Cho
Ja Eun Lee
Heejoon Jeong
Ji-Hye Kwon
Yu Jeong Bang
Gaabsoo Kim
author_facet Yoonjee Cho
Ja Eun Lee
Heejoon Jeong
Ji-Hye Kwon
Yu Jeong Bang
Gaabsoo Kim
author_sort Yoonjee Cho
collection DOAJ
description Many studies have reported that hypoalbuminemia could be associated with organ failure after liver transplantation. However, most of them focused on serum albumin levels measured at specific time points and not on the trend of serum albumin change. We investigated whether a cumulative postoperative change in serum albumin level up to postoperative day (POD) 5 is related to organ failure in patients who underwent living-donor liver transplantation (LDLT). Data of adult recipients who underwent LDLT between January 2016 and December 2020 at a single tertiary hospital were reviewed (n = 399). After screening, three patients were excluded because of insufficient data. A cumulative change in serum albumin level was demonstrated using the area under the threshold (AUT, threshold = 3.0 g/dL) of the serum albumin curve up to POD 5. Based on the AUT, the patients were divided into a high-decrease group (n = 156) and a low-decrease group (n = 240). All analyses were conducted using 1:1 propensity score matching. The primary endpoint was the Sequential Organ Failure Assessment (SOFA) score on POD 5. The secondary endpoints were postoperative hospital stay and postoperative 90-day mortality. A total of 162 patients were included. The SOFA score on POD 5 was significantly higher in the High-decrease group compared with the Low-decrease group (5.2 ± 2.6 vs. 4.1 ± 2.3; mean difference: 1.1, 95% CI: 0.3 to 1.8; P = 0.005). However, the length of postoperative hospital stay (P = 0.661) and 90-day mortality (P = 0.497) did not differ between the groups. In conclusion, a cumulative postoperative change in serum albumin level up to POD 5 could help predict postoperative organ failure on POD 5 in patients who underwent LDLT.
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spelling doaj.art-6c29026fca334c549f990df9348245e02023-06-17T05:31:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01185e028573410.1371/journal.pone.0285734Cumulative postoperative change in serum albumin levels and organ failure after living-donor liver transplantation: A retrospective cohort analysis.Yoonjee ChoJa Eun LeeHeejoon JeongJi-Hye KwonYu Jeong BangGaabsoo KimMany studies have reported that hypoalbuminemia could be associated with organ failure after liver transplantation. However, most of them focused on serum albumin levels measured at specific time points and not on the trend of serum albumin change. We investigated whether a cumulative postoperative change in serum albumin level up to postoperative day (POD) 5 is related to organ failure in patients who underwent living-donor liver transplantation (LDLT). Data of adult recipients who underwent LDLT between January 2016 and December 2020 at a single tertiary hospital were reviewed (n = 399). After screening, three patients were excluded because of insufficient data. A cumulative change in serum albumin level was demonstrated using the area under the threshold (AUT, threshold = 3.0 g/dL) of the serum albumin curve up to POD 5. Based on the AUT, the patients were divided into a high-decrease group (n = 156) and a low-decrease group (n = 240). All analyses were conducted using 1:1 propensity score matching. The primary endpoint was the Sequential Organ Failure Assessment (SOFA) score on POD 5. The secondary endpoints were postoperative hospital stay and postoperative 90-day mortality. A total of 162 patients were included. The SOFA score on POD 5 was significantly higher in the High-decrease group compared with the Low-decrease group (5.2 ± 2.6 vs. 4.1 ± 2.3; mean difference: 1.1, 95% CI: 0.3 to 1.8; P = 0.005). However, the length of postoperative hospital stay (P = 0.661) and 90-day mortality (P = 0.497) did not differ between the groups. In conclusion, a cumulative postoperative change in serum albumin level up to POD 5 could help predict postoperative organ failure on POD 5 in patients who underwent LDLT.https://doi.org/10.1371/journal.pone.0285734
spellingShingle Yoonjee Cho
Ja Eun Lee
Heejoon Jeong
Ji-Hye Kwon
Yu Jeong Bang
Gaabsoo Kim
Cumulative postoperative change in serum albumin levels and organ failure after living-donor liver transplantation: A retrospective cohort analysis.
PLoS ONE
title Cumulative postoperative change in serum albumin levels and organ failure after living-donor liver transplantation: A retrospective cohort analysis.
title_full Cumulative postoperative change in serum albumin levels and organ failure after living-donor liver transplantation: A retrospective cohort analysis.
title_fullStr Cumulative postoperative change in serum albumin levels and organ failure after living-donor liver transplantation: A retrospective cohort analysis.
title_full_unstemmed Cumulative postoperative change in serum albumin levels and organ failure after living-donor liver transplantation: A retrospective cohort analysis.
title_short Cumulative postoperative change in serum albumin levels and organ failure after living-donor liver transplantation: A retrospective cohort analysis.
title_sort cumulative postoperative change in serum albumin levels and organ failure after living donor liver transplantation a retrospective cohort analysis
url https://doi.org/10.1371/journal.pone.0285734
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