title: Adult living donor versus deceased donor liver transplantation: a 6-year single center experience.
abstract: No long-term (>3 years) prospective comparison of adult-to-adult living donor liver transplantation (A2ALLTx) to adult deceased donor liver transplantation (ADDLTx) has been reported. This is a prospective, IRB approved, 6-year comparison of A2ALLTx to ADDLTx. Data include: age, gender, ethnicity, primary liver disease, waiting time, pretransplant CTP/MELD score, cold ischemia time (CIT), perioperative mortality, acute and chronic rejection, graft and patient survival, charges and post-transplant complications. In 6 years, 202 ADDLTx (74.5%) and 69 A2ALLTx (25.5%) were performed at VCUHS. Hepatitis C virus (HCV) was the most common reason for transplantation in both groups (48.1% vs. 42%). Data regarding overall patient and graft survival, monetary charges and retransplantation rates were similar. Comparison of patient/graft survivals, retransplantation rates in patients with and without HCV were not statistically different. A2ALLTx patients had less acute rejection (11.5% vs. 23.9%) and more biliary complications (26.1% vs. 11.4%). Overall, A2ALLTx is as durable a liver replacement technique as the ADDLTx. Patients with A2ALLTx were younger, had lower MELD scores, less acute rejection and similar histological HCV recurrence. Biliary complications were more common in A2ALLTx but were not associated with increased graft loss compared to ADDLTx.
authors.affiliation: Division of Transplantation, Department of Surgery, Virginia Commonwealth University Health System, Richmon, VA, USA.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Maluf
authors.forename: Richard Todd
authors.initials: RT
authors.lastname: Stravitz
authors.forename: Adrian H
authors.initials: AH
authors.lastname: Cotterell
authors.forename: Marc P
authors.initials: MP
authors.lastname: Posner
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Nakatsuka
authors.forename: Richard K
authors.initials: RK
authors.lastname: Sterling
authors.forename: Velimir A
authors.initials: VA
authors.lastname: Luketic
authors.forename: Mitchell L
authors.initials: ML
authors.lastname: Shiffman
authors.forename: John M
authors.initials: JM
authors.lastname: Ham
authors.forename: Amadeo
authors.initials: A
authors.lastname: Marcos
authors.forename: Martha K
authors.initials: MK
authors.lastname: Behnke
authors.forename: Robert A
authors.initials: RA
authors.lastname: Fisher
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002102:Cadaver; D003080:Cold Temperature; D005260:Female; D006085:Graft Survival; D016174:Hepacivirus / Q000378:metabolism; D006526:Hepatitis C / Q000401:mortality / Q000473:pathology / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007511:Ischemia; D008099:Liver; D008107:Liver Diseases / Q000209:etiology; D017093:Liver Failure / Q000628:therapy; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods
chemical_list: D007166:Immunosuppressive Agents