Factors Associated with Mortality Within 24h of Liver Transplantation: An Updated Analysis of 65,308 Adult Liver Transplant Recipients Between 2002 and 2013

STUDY OBJECTIVES: Intracardiac and pulmonary thromboembolism (ICPTE), its risk factors and contribution to 24-hour mortality after adult liver transplantation for end-stage liver disease. DESIGN: Retrospective analysis of Standard Transplant Analysis and Research electronic database files. SETTING: Perioperative. PATIENTS: Electronic files of 65,308 adult liver transplant recipients between 2002 and 2013 obtained from Organ Procurement and Transplantation Network. INTERVENTIONS: Mortality cause analysis and design of a multivariable logistic regression model for predicting the risk of 24-hour mortality due to devastating ICPTE. MEASUREMENTS: Perioperative mortality, donor and recipient demographics, donor cause of death, graft ischemic times, etiologies of recipient end-stage liver disease, functional status, comorbidities, and laboratory values. MAIN RESULTS: 41,324 patients were included. 38,293 (92.6%) survived 30 days after transplantation. Postoperative 24-hour mortality was 547 (1.3%) and 2484 (6.0%) within subsequent 30days. Uncontrolled hemorrhage (57 patients, 0.14%), devastating ICPTE (54 patients, 0.13%) and primary graft failure (49 patients, 0.12%) contributed the most and equally to the 24-hour mortality. For the ICPTE, recipients\u27 prior history of pulmonary embolism, portal vein thrombosis, functional status (Karnofsky score