title: Liver transplantation in the Nordic countries - An intention to treat and post-transplant analysis from The Nordic Liver Transplant Registry 1982-2013.
abstract: OBJECTIVE
  The Nordic Liver Transplant Registry (NLTR) accounts for all liver transplants performed in the Nordic countries since the start of the transplant program in 1982. Due to short waiting times, donor liver allocation has been made without considerations of the model of end-stage liver disease (MELD) score. We aimed to summarize key outcome measures and developments for the activity up to December 2013.
  
  
  METHODS
  The registry is integrated with the operational waiting-list and liver allocation system of Scandiatransplant (www.scandiatransplant.org) and accounted at the end of 2013 for 6019 patients out of whom 5198 were transplanted. Data for recipient and donor characteristics and relevant end-points retransplantation and death are manually curated on an annual basis to allow for statistical analysis and the annual report.
  
  
  RESULTS
  Primary sclerosing cholangitis, acute hepatic failure, alcoholic liver disease, primary biliary cirrhosis and hepatocellular carcinoma are the five most frequent diagnoses (accounting for 15.3%, 10.8%, 10.6%, 9.3% and 9.0% of all transplants, respectively). Median waiting time for non-urgent liver transplantation during the last 10-year period was 39 days. Outcome has improved over time, and for patients transplanted during 2004-2013, overall one-, five- and 10-year survival rates were 91%, 80% and 71%, respectively. In an intention-to-treat analysis, corresponding numbers during the same time period were 87%, 75% and 66%, respectively.
  
  
  CONCLUSIONS
  The liver transplant program in the Nordic countries provides comparable outcomes to programs with a MELD-based donor liver allocation system. Unique features comprise the diagnostic spectrum, waiting times and the availability of an integrated waiting list and transplant registry (NLTR).
authors.affiliation: Section for Transplantation Surgery, Department of Transplantation Medicine, Division of Cancer, Surgery and Transplantation, Oslo University Hospital , Oslo , Norway.
authors.forename: Bjarte
authors.initials: B
authors.lastname: Fosby
authors.forename: Espen
authors.initials: E
authors.lastname: Melum
authors.forename: Kristian
authors.initials: K
authors.lastname: Bjøro
authors.forename: William
authors.initials: W
authors.lastname: Bennet
authors.forename: Allan
authors.initials: A
authors.lastname: Rasmussen
authors.forename: Ina Marie
authors.initials: IM
authors.lastname: Andersen
authors.forename: Maria
authors.initials: M
authors.lastname: Castedal
authors.forename: Michael
authors.initials: M
authors.lastname: Olausson
authors.forename: Christina
authors.initials: C
authors.lastname: Wibeck
authors.forename: Mette
authors.initials: M
authors.lastname: Gotlieb
authors.forename: Henrik
authors.initials: H
authors.lastname: Gjertsen
authors.forename: Leena
authors.initials: L
authors.lastname: Toivonen
authors.forename: Stein
authors.initials: S
authors.lastname: Foss
authors.forename: Heikki
authors.initials: H
authors.lastname: Makisalo
authors.forename: Arno
authors.initials: A
authors.lastname: Nordin
authors.forename: Truls
authors.initials: T
authors.lastname: Sanengen
authors.forename: Annika
authors.initials: A
authors.lastname: Bergquist
authors.forename: Marie E
authors.initials: ME
authors.lastname: Larsson
authors.forename: Gunnar
authors.initials: G
authors.lastname: Soderdahl
authors.forename: Greg
authors.initials: G
authors.lastname: Nowak
authors.forename: Kirsten Muri
authors.initials: KM
authors.lastname: Boberg
authors.forename: Helena
authors.initials: H
authors.lastname: Isoniemi
authors.forename: Susanne
authors.initials: S
authors.lastname: Keiding
authors.forename: Aksel
authors.initials: A
authors.lastname: Foss
authors.forename: Pål-Dag
authors.initials: PD
authors.lastname: Line
authors.forename: Styrbjörn
authors.initials: S
authors.lastname: Friman
authors.forename: Erik
authors.initials: E
authors.lastname: Schrumpf
authors.forename: Bo-Göran
authors.initials: BG
authors.lastname: Ericzon
authors.forename: Krister
authors.initials: K
authors.lastname: Höckerstedt
authors.forename: Tom H
authors.initials: TH
authors.lastname: Karlsen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis / Q000379:methods*; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012042:Registries; D012086:Reoperation; D012189:Retrospective Studies; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D009927:Tissue and Organ Procurement / Q000379:methods*; D014850:Waiting Lists
keywords: end-stage liver disease; indication; liver transplantation; organ allocation; outcome; registry