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01.09.2010 | Original Article | Ausgabe 9/2010

Journal of Gastrointestinal Surgery 9/2010

Living Donor and Deceased Donor Liver Transplantation for Autoimmune and Cholestatic Liver Diseases—An Analysis of the UNOS Database

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 9/2010
Autoren:
Randeep Kashyap, Saman Safadjou, Rui Chen, Parvez Mantry, Rajeev Sharma, Vrishali Patil, Manoj Maloo, Charlotte Ryan, Carlos Marroquin, Christopher Barry, Gopal Ramaraju, Benedict Maliakkal, Mark Orloff
Wichtige Hinweise
This paper was presented as an oral presentation at ATC meeting 2008 Toronto, Canada.
Randeep Kashyap participated in research design, writing of the paper, and data analysis. Saman Safadjou participated in research design and data analysis. Rui Chen, Rajeev Sharma, and Vrishali Patil participated in data analysis. Parvez Mantry, Manoj Maloo, Gopal Ramaraju and Benedict Maliakkal participated in research design. Charlotte Ryan participated in the writing of the paper. Carlos Marroquin and Christopher Barry participated in the performance of the research. Mark Orloff participated in research design, writing of the paper, and performance of the research.

Abstract

Introduction

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.

Aim

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.

Patients and 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.

Conclusion

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.

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