Status 1 Liver Transplantation: Changes in Characteristics and Outcome Over Time.
General Surgery, University of Hawaii, JABSOM, Honolulu, HI
Meeting: 2017 American Transplant Congress
Abstract number: C187
Keywords: Graft survival, Liver transplantation, Retransplantation
Session Information
Session Name: Poster Session C: Organ Allocation, Meld Score, Organ Utilization, and Transplant Outcomes
Session Type: Poster Session
Date: Monday, May 1, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Purpose: Approximately 5% of liver transplants (LT) annually require this urgently as “Status 1." The aim of this study is to characterize patients who received LT as a status 1 over a 13 year period and identify changes that have occurred over time.
Methods: This retrospective review of the Scientific Registry of Transplant Patients 2003-2015 included 2408 adult status 1 transplants. This cohort was divided into two 6.5 year groups. Data collected: recipient /donor age, ethnicity, gender, ABO blood type, wait time, survival. Etiology was characterize into: drug-induced liver injury (DILI), viral, autoimmune, re-transplantation, chronic problems, metabolic disease, other, unspecified fulminant hepatic failure. The main outcomes included mean wait time and survival.
Results: Fewer LT were performed in Era2. Era2 patients were older, less likely be ABO-incompatible, or re-transplant. There was no difference in the incidence of DILI, however, Era2 had more herbal/dietary supplement cases. There were no difference in 3-year but 1-year and 5-year survival improved in Era2. Mean wait time was shorter in Era2 but there was no difference in those waited ≤7 days. Long mean wait times were noted in autoimmune and chronic diseases especially compared to DILI.
| Era1 (1309) | Era2 (1099) | P value | |
| Mean recipient age (yrs) | 41.7 | 43.2 | 0.025 |
| Mean waiting time (d) | 56.7 | 41.4 | 0.005 |
| Waiting time ≤7 days (%) | 981 (74.9) | 846 (77.0) | 0.25 |
| Mean donor age (yrs) | 38.8 | 37.1 | 0.011 |
| ABO incompatible | 2.4% | 1.1% | 0.014 |
| Graft failure | 18.6% | 8% | <0.001 |
| Re-transplant | 9.2% | 3.6% | <0.001 |
| 1 year pt survival | 83.4 % | 88.1% | 0.002 |
| 3 year pt survival | 77.5% | 85.7% | 0.395 |
| 5 year pt survival | 74.7% | 63.6% | 0.001 |
| Mean wait time Autoimmune (d) | 186.0 | 149.4 | 0.44 |
| Mean wait time Chronic Problems (d) | 300.7 | 116.1 | 0.28 |
| Mean wait time DILI (d) | 9.3 | 7.6 | 0.68 |
Conclusions: Despite the increase in recipient and donor age, there has been improvement in use of LT for status 1 patients over time with fewer cases, less re-transplantation, less need for ABO incompatible transplant, lower mean waiting time, and excellent survival. Long wait times for autoimmune and chronic diseases as status 1 raises issues about listing practices and should be investigated further.
CITATION INFORMATION: Truong H, Lacar L, Wong L. Status 1 Liver Transplantation: Changes in Characteristics and Outcome Over Time. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Truong H, Lacar L, Wong L. Status 1 Liver Transplantation: Changes in Characteristics and Outcome Over Time. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/status-1-liver-transplantation-changes-in-characteristics-and-outcome-over-time/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress