title: Living donor and deceased donor liver transplantation for autoimmune and cholestatic liver diseases--an analysis of the UNOS database.
abstract: BACKGROUND
  Autoimmune hepatitis and cholestatic liver diseases have more favorable outcomes after liver transplantation as compared to viral hepatitis and alcoholic liver diseases. However, there are only few reports comparing outcomes of both living donor liver transplants (LDLT) and deceased donor liver transplants (DDLT) for these conditions.
  
  
  OBJECTIVE
  We aim to study the survival outcomes of patients undergoing LT for autoimmune and cholestatic diseases and to identify possible risk factors influencing survival. Survival outcomes for LDLT vs. DDLT are also to be compared for these diseases.
  
  
  METHODS
  A retrospective analysis of the UNOS database for patients transplanted between February 2002 until October 2006 for AIH, PSC, and PBC was performed. Survival outcomes for LDLT and DDLT patients were analyzed and factors influencing survival were identified.
  
  
  RESULTS
  Among all recipients the estimated patient survival at 1, 3, and 5 years for LDLT was 95.5%, 93.6%,and 92.5% and for DDLT was 90.9%, 86.5%, and 84.9%, respectively (p = 0.002). The estimated graft survival at 1, 3, and 5 years for LDLT was 87.9%, 85.4%, and 84.3% and for DDLT 85.9%, 80.3%, and 78.6%, respectively (p = 0.123). On multivariate proportional hazard regression analysis after adjusting for age and MELD score, the effect of donor type was not found to be significant.
  
  
  CONCLUSIONS
  The overall survival outcomes of LDLT were similar to DDLT in our patients with autoimmune and cholestatic liver diseases. It appears from our study that after adjusting for age and MELD score donor type does not significantly affect the outcome.
authors.affiliation: Department of Surgery, Division of Solid Organ Transplantation, University of Rochester Medical Center, P.O. Box SURG, 601 Elmwood Avenue, Rochester, NY 14642, USA. randeep_kashyap@urmc.rochester.edu
authors.forename: Randeep
authors.initials: R
authors.lastname: Kashyap
authors.forename: Saman
authors.initials: S
authors.lastname: Safadjou
authors.forename: Rui
authors.initials: R
authors.lastname: Chen
authors.forename: Parvez
authors.initials: P
authors.lastname: Mantry
authors.forename: Rajeev
authors.initials: R
authors.lastname: Sharma
authors.forename: Vrishali
authors.initials: V
authors.lastname: Patil
authors.forename: Manoj
authors.initials: M
authors.lastname: Maloo
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ryan
authors.forename: Carlos
authors.initials: C
authors.lastname: Marroquin
authors.forename: Christopher
authors.initials: C
authors.lastname: Barry
authors.forename: Gopal
authors.initials: G
authors.lastname: Ramaraju
authors.forename: Benedict
authors.initials: B
authors.lastname: Maliakkal
authors.forename: Mark
authors.initials: M
authors.lastname: Orloff
mesh_terms: D000328:Adult; D015209:Cholangitis, Sclerosing / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D019693:Hepatitis, Autoimmune / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology