Liver transplant complications in the first 30 days – assessment tool of the transplant system in the state of Paraná

Abstract

Purpose: To identify and quantify complications in the first 30 days of cadaveric donor liver transplantation by using the Clavien-Dindo classification according to the DRI, P-SOFT, SOFT, MELD and BAR scores. To propose adoption of a prospective follow-up of these data in the Paraná State Transplant System. Methods: Observational cohort of THF cases from the Rocio Hospital program, Campo Largo, Paraná along 2016 and 2017. Results: a significant increase in the severity index represented by MELD with 20.2+4.8 (2016) and 24. 4 +7.11 (2017), with p = 0.0076. There were no significant differences in BAR (8.03+3.86 vs 9.54+4.11), PSOFT (12.38 + 6.43 vs 11.83+7.83) and SOFT (12.32+7,6). There was an increased incidence of Grade IVb and V complications. The surgical mortality rate was 9.68% in 2016, and 35.85% in 2017. Conclusion: There was an increasing severity of MELD among receptors, with increased mortality due to infectious complications. The adoption of prospective follow-up of liver transplantation data in the state of Paraná, with projections of the severity sub-groups according to the adopted indices will serve as critical basis for continuous improvement, transparency and better targeting of health system resources.