title: Evolution of liver transplantation in Europe: report of the European Liver Transplant Registry.
abstract: The European Liver Transplant Registry (ELTR) currently allows for the analysis of 44,286 liver transplantations (LTs) performed on 39,196 patients in a 13-year period. After an exponential increase, the number of LTs is plateauing due to a lack of organs. To cope with this, alternatives to cadaveric LT, such as split LT, domino LT, or living-related LT (LRLT) are being used increasingly. They now account for 11% of all procedures. One of the most important findings in the evolution of LT is the considerable improvement of results along time with, for the mean time, a one-year survival of 83%, all indications confounded. The improvement is particularly significant for cancers. This improvement is mainly represented by hepatocellular carcinoma, with a gain of 17% for 5-year survival rate from 1990 to 2000. Increasingly, older donors are used to augment the donor pool and older recipients are transplanted due to improved results and a better selection of patients. More than two thirds of deaths and three quarters of retransplantations occurred within the first year of transplantation. Retransplantation is associated with much less optimal results than first LT. One of the prominent features of recent years is the development of LRLT. LRLT is now performed by almost half of the European centers. As with split LT or domino LT, LRLT aims to provide more patients to be transplanted. Special attention is paid to reducing the risk for the donor, which is now estimated to be 0.5% mortality and 21% postoperative morbidity.
authors: European Liver Transplant Registry, Villejuif, France. rene.adam@pbr.ap-hop-paris.fr
authors: René
authors: R
authors: Adam
authors: Paul
authors: P
authors: McMaster
authors: John G
authors: JG
authors: O'Grady
authors: Denis
authors: D
authors: Castaing
authors: Jurgen L
authors: JL
authors: Klempnauer
authors: Neville
authors: N
authors: Jamieson
authors: Peter
authors: P
authors: Neuhaus
authors: Jan
authors: J
authors: Lerut
authors: Mauro
authors: M
authors: Salizzoni
authors: Stephen
authors: S
authors: Pollard
authors: Ferdinand
authors: F
authors: Muhlbacher
authors: Xavier
authors: X
authors: Rogiers
authors: Juan Carlos
authors: JC
authors: Garcia Valdecasas
authors: Joaquin
authors: J
authors: Berenguer
authors: Daniel
authors: D
authors: Jaeck
authors: Enrique
authors: E
authors: Moreno Gonzalez
mesh_terms: D005060:Europe; D006801:Humans; D008107:Liver Diseases / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D019520:Living Donors / Q000706:statistics & numerical data; D012042:Registries; D012086:Reoperation; D016019:Survival Analysis; D014019:Tissue Donors / Q000706:statistics & numerical data; D009927:Tissue and Organ Procurement