Factors Influencing Survival in the First Year Post Liver Transplantation Among Iraqi Patients

Background: Liver transplantation has transformed medicine, especially for patients with advanced liver disease and hepatocellular carcinoma, improving their lifespan and quality of life. Objective: To assess the one-year survival rate post-liver transplantation and analyze the factors influencing survival. Methods: A retrospective study conducted at Baghdad Gastroenterology Hospital analyzed data from liver transplant referrals over the last 5 years, based on the Model for End-Stage Liver Disease score. 100 patients were classified as children (≤18 years) and adults (≥19 years) and followed up for one year post-transplant. Mortality analysis considered various etiological, clinical, and sociodemographic factors. Results: In adults, males were predominant among both patients (66%) and donors (71.7%). The most frequent cause was cryptogenic cirrhosis (39.62%), then viral and autoimmune hepatitis (20.75% and 18.87%), respectively. Of the 53 adult patients, 5 died (9.43%), and 48 survived (90.57%). The age gap and BMI were significantly different. In pediatrics, biliary atresia was the most common cause (36.17%). Of the 47 pediatric patients, 16 died (34%) and 31 survived (66%). However, there were notable differences in the causes of liver cirrhosis between deceased and surviving patients. BMI and age gap between donors and recipients significantly affect survival in adults, while biliary atresia, Caroli disease, and hyperoxaluria have the highest one-year mortality in pediatric patients. Conclusions: Over 90% of adults and 66% of children survive a year after receiving a liver transplant; in adults, age and BMI differences have a major impact. In contrast, pediatric survival was affected by the etiology of cirrhosis.