Living Donor Liver Transplantation Demonstrated Superiority to Deceased Donor Transplantation after Adult-To-Adult Liver Transplantation in Cumulative Single-Center Retrospective Cohort Study of 19 Years
Multi-Organ Transplant Program, Toronto General Hospital, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
Meeting: 2020 American Transplant Congress
Abstract number: 367
Keywords: Graft survival, Liver transplantation, Living donor, Survival
Session Information
Session Name: Liver: Living Donors and Partial Grafts I
Session Type: Oral Abstract Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:45pm
Presentation Time: 4:15pm-4:27pm
Location: Virtual
*Purpose: Living donor liver transplantation (LDLT) is an alternative way to deceased donor liver transplantation (DDLT). LDLT and DDLT showed similar short-term outcomes of recipient and graft survival, however the long-term outcomes are not well reported. This is a single-center, retrospective, cohort study to summarize the cumulative 19 year-experience of our liver transplant program.
*Methods: We analyzed primary adult-to-adult liver transplantation between January 2000 and September 2018 in our center. Patients with graft from donor after cardiocirculatory death or domino liver transplant, and patients who underwent other solid organ transplantations were excluded. The primary endpoint was the long-term patient and graft survival, and causes of recipient’s death and/or graft loss in both groups.
*Results: A total of 2144 recipients were enrolled in this study: 628 LDLT and 1516 DDLT. There was a significant difference in etiology of original diseases (P < 0.0001) with more patients being transplanted for hepatoma in the DDLT group (44.6% vs. 25.8 %, P < 0.0001), while autoimmune and biliary diseases were more common indication in the LDLT group (28.5% vs. 11.6%, P < 0.0001). LDLT recipients had lower MELD score at transplant (17.1 vs. 19.0, P = 0.055) and shorter waiting time from listing (211.4 vs. 268.0 days, P = 0.078). Patient survival was significantly higher at 10 and 15 years after transplant in the LDLT group (73.4% and 57.6% in LDLT, vs 66.6% and 53.4% in DDLT respectively, P = 0.024). No significant difference was seen in graft survival. (P = 0.372). LDLT was associated with a higher re-transplantation rate (6.7% vs. 2.5%, P < 0.0001). No difference was observed regarding the cause of death between LDLT and DDLT patients during the follow-up (all term: P = 0.078, after 5 years of transplant: P = 0.062, after 10 years of transplant P = 0.409). Multivariate analysis demonstrated that recipients’ hepatitis C was the only significant risk factor for recipient survival at 10 years in both groups (OR 1.560, CI (95%) 1.199-2.030, P = 0.0009 in LDLT, OR 1.496, CI (95%) 1.141-1.961, P = 0.004 in DDLT).
*Conclusions: Despite many differences in donor and recipient background, LDLT offered significantly better long-term recipient survival in our cohort study.
To cite this abstract in AMA style:
Goto T, Reichman T, Sapisochin G, McGilvray I, Selzner M, Ghanekar A, Cattral M, Selzner N. Living Donor Liver Transplantation Demonstrated Superiority to Deceased Donor Transplantation after Adult-To-Adult Liver Transplantation in Cumulative Single-Center Retrospective Cohort Study of 19 Years [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/living-donor-liver-transplantation-demonstrated-superiority-to-deceased-donor-transplantation-after-adult-to-adult-liver-transplantation-in-cumulative-single-center-retrospective-cohort-study-of-19-ye/. Accessed May 25, 2025.« Back to 2020 American Transplant Congress