{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T23:42:40Z","timestamp":1781307760591,"version":"3.54.1"},"reference-count":60,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T00:00:00Z","timestamp":1622073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto de Salud Carlos III (ISCIII)","award":["PI15\/01370 and P19\/01194"],"award-info":[{"award-number":["PI15\/01370 and P19\/01194"]}]},{"name":"European Union with European Fund of Regional Development (FEDER)","award":["\u201cA manner to build Europe\u201d"],"award-info":[{"award-number":["\u201cA manner to build Europe\u201d"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background. Clinical and molecular mechanisms involved in the cause and time of death of alcoholic cirrhosis (AC) patients undergoing liver transplantation (LT) are not entirely understood. In sudden death cases, judicial autopsy practice is mandatory for determining the cause and circumstances of death. The medico-legal autopsy data are essential for helping health authorities to guide future public health activities, assess the effectiveness of health systems, and adopt the necessary preventive measures to improve and adapt the treatments in order to increase these patients\u2019 survival. Objective. Our study aimed to determine the different clinical and sociodemographic causes that influence the different causes of death and the short- and long-term survival of AC patients undergoing liver transplantation. Methods. A total of 122 deceased AC patients undergoing LT were analyzed at different times post-transplantation. The main pre- and post-transplant complications were analyzed in relation to the cause of death and the patient\u2019s survival, as well as the causes and time at which the patient\u2019s death occurred. Results. A total of 53.3% of non-sudden death was observed. A large number of the deaths of AC patients undergoing transplantation were due to non-sudden death, sepsis, and graft failure (GF), the main causes of death in the sample being similar in both sexes. In non-sudden deaths, there were no significant differences between the death rates either related or not related to the liver transplant. Sepsis was the main cause, with the highest percentage (21.3%) of mortality, followed by GF (18.9%) and multiorgan failure (15.6%) at ten years. Furthermore, our results showed how pre-transplant clinical complications, such as viral infections and encephalopathy, influence the age at which multiorgan failure occurs in the transplanted patient. Conclusion. Multiorgan failure is the leading cause of sudden death, with higher mortality during the first year after transplantation, followed by sepsis and GF. Our results show the vulnerability of AC patients, both in the hospital period after the transplant and outside.<\/jats:p>","DOI":"10.3390\/diagnostics11060968","type":"journal-article","created":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T11:07:02Z","timestamp":1622113622000},"page":"968","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Causes of Death and Survival in Alcoholic Cirrhosis Patients Undergoing Liver Transplantation: Influence of the Patient\u2019s Clinical Variables and Transplant Outcome Complications"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2400-9213","authenticated-orcid":false,"given":"J. M.","family":"Bolar\u00edn","sequence":"first","affiliation":[{"name":"Department of Legal and Forensic Medicine, Faculty of Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence \u201cCampus Mare Nostrum\u201d, University of Murcia, 30100 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1879-2969","authenticated-orcid":false,"given":"M. D.","family":"P\u00e9rez-C\u00e1rceles","sequence":"additional","affiliation":[{"name":"Department of Legal and Forensic Medicine, Faculty of Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence \u201cCampus Mare Nostrum\u201d, University of Murcia, 30100 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1168-7525","authenticated-orcid":false,"given":"J. P.","family":"Hern\u00e1ndez del Rinc\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Legal and Forensic Medicine, Faculty of Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence \u201cCampus Mare Nostrum\u201d, University of Murcia, 30100 Murcia, Spain"},{"name":"Forensic Pathology Department, Institute of Legal and Forensic Medicine, 30100 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7760-7415","authenticated-orcid":false,"given":"A.","family":"Luna","sequence":"additional","affiliation":[{"name":"Department of Legal and Forensic Medicine, Faculty of Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence \u201cCampus Mare Nostrum\u201d, University of Murcia, 30100 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2472-5893","authenticated-orcid":false,"given":"A.","family":"Minguela","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), Immunology Service, Instituto Murciano de Investigaci\u00f3n Biosanitaria (IMIB), Hospital Cl\u00ednico Universitario Virgen de la Arrixaca (HCUVA), 30120 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9987-0994","authenticated-orcid":false,"given":"M.","family":"Muro","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), Immunology Service, Instituto Murciano de Investigaci\u00f3n Biosanitaria (IMIB), Hospital Cl\u00ednico Universitario Virgen de la Arrixaca (HCUVA), 30120 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1140-4313","authenticated-orcid":false,"given":"I.","family":"Legaz","sequence":"additional","affiliation":[{"name":"Department of Legal and Forensic Medicine, Faculty of Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence \u201cCampus Mare Nostrum\u201d, University of Murcia, 30100 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"682","DOI":"10.5114\/aoms.2018.80651","article-title":"Pretransplant ascites or encephalopathy and their influence on survival and liver graft rejection in alcoholic cirrhosis disease","volume":"17","author":"Legaz","year":"2021","journal-title":"Arch. 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