Alba Gomez Barrena, Spain has been granted the TTS-SET Basic and Translational Mentee-Mentor Award
Tobacco influence on short-term outcomes of liver transplantation
Alba Gómez Barrena1, Iago Justo Alonso1, Alberto Marcacuzco Quinto1, Oscar Caso Maestro1, Félix Cambra Molero1, Álvaro García-Sesma Perez-Fuentes1, Alejandro Manrique Municio1, Jorge Calvo Pulido1, Manuel Abradelo de Usera1, Carmelo Loinaz Segurola1.
1University Hospital 12 de Octubre, Madrid, Spain
Introduction: Tobacco consumption is strongly associated with the onset of cancer and cardiovascular diseases, but in some recent articles on transplant patients, it has also been associated with vascular and biliary complications. Likewise, a close relationship with post-transplant arterial thrombosis has been demonstrated.
Materials and Methods: From January 1, 2014, to August 31, 2023, we performed 523 liver transplants. We selected a sample of 489 patients with follow-up until March 3, 2024, dividing the sample into three groups: Smokers (S) (132 patients); Non-smokers (NS) (184 patients); and Former smokers (FS) (173 patients). Pediatric recipients, those with insufficient data, and those receiving multi-visceral transplants were excluded.
Results: The mean ages in the groups were: S 56 (22-71) years; NS 58 (18-74) years, and FS 60 (29-70) years (p=0.002). The BMI among the groups was: S 25.2 (14.2-37.8); NS 26.5 (15.7-46.8); and FS 26.4 (16.6-41) (p=0.120). The incidence of HCV cirrhosis was 44.8% in group S, 43.7% in group NS, and 43.1% in group FS (p=0.967). The incidence of Hepatocellular carcinoma was 19.8% in group S; 24.5% in group NS, and 24.5% in group FS (p=0.242).
The MELD score was 12 (6-33) in group S, 14 (6-46) in group NS, and 12 (6-36) in FS (p=0.028). The preoperative portal thrombosis rate was 6.9% complete and 12.1% partial in group S; 12.6% complete and 9.2% partial in group NS; and 12.7% complete and 14.7% partial in group FS (p=0.238). The ICU stay was 4 days (1-68) in S; 4 (1-165) in NS, and 4 (1-41) in FS (p=0.157). The ward stay was 10 days (3-78) in S; 9 (1-120) in NS, and 10 (3-82) in FS (p=0.630). Blood transfusion was 2 (0-70) in S; 4 (0-56) in NS, and 2 (0-71) in FS (p=0.038), plasma transfusion was 3 (0-60) in S; 5 (0-58) in NS, and 3 (0-50) in FS (p=0.001). The actuarial survival at 1, 3, and 5 years was in each group: 86.4%, 84.3%, and 83.1% in group NS; 92.5%, 86.5%, and 83.2% in group FS; and 89.4%, 81.7%, and 77.5% in group S (p=0.216).
Conclusion: We did not find statistically significant differences among patients based on smoking habits. In our study, it does not represent a decisive factor for such complications.
