It is widely reported that outcomes have steadily improved in liver transplantation over the past 3 decades. The national benchmark of 1-year survival is now over 90%.

Objective: Taking improved short term survival outcomes as a given, we sought to analyze the long-term outcomes of 1-year survivors following liver transplantation.

Methods: The United Network for Organ Sharing provided de-identified patient-level data. We analyzed 127,697 recipients of liver transplantation from 1987 to 2016. We included liver-kidney transplants but excluded all other types of multi- and re-transplants. Kaplan-Meier and Cox regression multivariate analyses were performed including age, ventilator and dialysis dependence.

Results: Over the study period (1987 vs 2016), 1-year survival following LT improved dramatically, (66% vs 91%, p <0.001) despite recipients that are now older (44.9 vs 55.7 years, p <0.001) and sicker (0.1% dialysis vs 16.6%, p <0.001). In stark contrast, there was no improvement in long-term survival after surviving the first year following transplantation (67.5% 10 year-survival in 1987 vs 66.3% in 2006). Multivariate analysis uncovered a minor improvement in long-term survival due to the fact that we transplant sicker patients in the modern era. Transplantation in the remote era vs modern era, long-term survival after surviving the first year: HR 1.27 (1.19-1.37).

Conclusion: One-year survival following liver transplantation has improved dramatically. Unadjusted long-term survival after the first year has not improved over the past 3 decades, leaving a focus for improvement.

CITATION INFORMATION: Rana A, Kueht M, Moffett J, Galvan N, Cotton R, Vierling J, Mindikoglu A, O'Mahony C, Goss J. No Gains in Long-Term Survival Following Liver Transplantation Over the Past Three Decades. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress