title: Peri-operative challenges and long-term outcomes in liver transplantation for polycystic liver disease.
abstract: BACKGROUND
  The purpose of this study was to determine peri-operative mortality and long-term outcomes in patients undergoing liver transplantation in the US using the United Network for Organ Sharing (UNOS) database.
  
  
  METHODS
  This study is a retrospective review of liver transplantations (LT) recorded in the UNOS database performed between 1988 and 2010. In total, 107 411 LT were performed in the US, 357 (0.3%) were for adult polycystic liver disease (PLD). A random group of 9416 adult patients transplanted for other diagnoses was created for comparison (10% of the adult non-PLD database).
  
  
  RESULTS
  Two hundred and seventy-one patients in the adult PLD group were females (75.9%), the mean age was 52.3 ± 8.2 [standard deviation (SD)] years. The median length of transplantation hospital stay was 11 days (interquartile range 8-21). Patients from the PLD group versus the comparison group (9416 patients) consisted of more females, lower Model for End-Stage Liver Disease (MELD) scores (17 versus 21 points), more multi-organ transplants (41% versus 4 %), chronic renal failure (creatinine 2.7 versus 1.5) and fewer patients with chronic hepatitis C (1.4% versus 32%). Peri-operative mortality (≤30 days) was 9% in the PLD versus 6% in the comparison group; however, at 1 year PLD survival was similar (85% versus 85%) to other diagnoses and better at 3 (81% versus 77%) and 5 years (77% versus 71%, overall Log Rank P = 0.006). A similar PLD survival advantage was observed in isolated initial transplants (P = 0.019).
  
  
  CONCLUSIONS
  In spite of early technical challenges and mortality, transplantation should be considered an option for selected patients with PLD as excellent long-term outcomes can be achieved.
authors: Transplant Center, University of Kentucky College of Medicine, Lexington, KY 40536-0293, USA. rgeda2@uky.edu
authors: Roberto
authors: R
authors: Gedaly
authors: Paige
authors: P
authors: Guidry
authors: Daniel
authors: D
authors: Davenport
authors: Michael
authors: M
authors: Daily
authors: Jens
authors: J
authors: Ronsenau
authors: Malay
authors: M
authors: Shah
authors: Michael A
authors: MA
authors: Cooper
authors: Jonathan
authors: J
authors: Hundley
mesh_terms: D000328:Adult; D003560:Cysts / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States