An analysis of liver transplant survival rates from the UNOS registry.
The annual number of liver transplants increased from 1,678 in 1988 to 6,139 in 2006 and appeared to decline slightly in 2007. Living donor (LD) liver transplants (most from biologically unrelated donors) increased from less than 100 each year prior to 1999 to 522 in 2001 and have slowly declined since. In 2007, 265 LD liver transplants were performed. Most of the increased activity in liver transplantation has been in the adult population. About 500 pediatric liver transplants are performed each year and the number has remained roughly constant since 1990. Pediatric LD liver recipients were significantly younger than deceased donor (DD) liver recipients. Unadjusted graft and patient survival rates were 61% and 71% at 7 years, respectively, for 2,375 LD recipients and 58% and 66%, respectively, for 71,686 DD recipients during 1988-2007. Five-year graft survival rates improved by 9% comparing transplants done in 1988-1993 to those done in 2002-2004. Adult female patients and recipients of a male donor graft had better survival rates, whereas recipient and donor gender in the pediatric age group showed no significant association with survival rates. Implementation of the MELD/PELD scoring system resulted in more patients with severe liver failure receiving DD grafts. Nevertheless, recipients transplanted from 2002 onwards showed improved graft survival. Comparing patients with different levels of MELD/PELD scores however, showed that the cohort with the highest score (> 30) had the worst survival, suggesting that improved survival rates since 2002 would be more likely attributed to the great progress in medical science.
Goh
Angeline
A
Terasaki Foundation Laboratory, Los Angeles, CA, USA.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001788:Blood Grouping and Crossmatching / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000208:ethnology / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control; D006085:Graft Survival; D054624:Health Status Disparities; D006801:Humans; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects / Q000208:ethnology / Q000401:mortality*; D019520:Living Donors / Q000600:supply & distribution; D008297:Male; D008875:Middle Aged; D012042:Registries; D018570:Risk Assessment; D012737:Sex Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult