Adult-to-Adult Living Donor Liver Transplantation in Acute Liver Failure - Do Outcomes Justify the Risks?

Adult-to-Adult Living Donor Liver Transplantation in Acute Liver Failure – Do Outcomes Justify the Risks?

A. Shingina¹, I. A. Ziogas², P. Vutien³, E. Uleryk⁴, E. Renner⁵, M. P. Bhat⁶, J. Tinmouth⁴, J. Kim⁷

¹Vanderbilt University, Nashville, TN, ²Division of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University Medical Center, Nashville, TN, ³University of Washington Medical Center, Seattle, WA, ⁴University of Toronto, Toronto, ON, Canada, ⁵University of Manitoba, Saskatchewan, MB, Canada, ⁶Multi-Organ Transplant, UHN, Toronto, ON, Canada, ⁷Toronto General Hospital, Toronto, ON, Canada

Meeting: 2022 American Transplant Congress

Abstract number: 1768

Keywords: Liver failure, Living donor, Living-related liver donors, Survival

Topic: Clinical Science » Liver » 58 - Liver: Living Donor Liver Transplant and Partial Grafts

Session Information

Session Name: Liver: Living Donor Liver Transplant and Partial Grafts

Session Type: Poster Abstract

Date: Tuesday, June 7, 2022

Session Time: 7:00pm-8:00pm

Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Living-donor Liver Transplantation(LDLT) has emerged as a safe and effective alternative in children and adults with pre-existing liver diseases. Utilization of LDLT for patients with acute liver failure has been limited by concerns regarding donor safety, donor consent process and recipient outcomes. Our objective was to conduct a systematic review and meta-analysis to investigate whether the concerns about subpar LDLT outcomes in patients with ALF are justified.

*Methods: We followed the PRISMA statement checklist conducted database searches in MEDLINE, Medline-in-Process, Medline Epub Ahead of Print and EMBASE + EMBASE Classic (OvidSP); and Cochrane (Wiley) on August 27, 2021. United Network for Organ Sharing (UNOS) database Standard Transplant Analysis and Research data file (released July 28, 2021) was queried for patients over the age of 18, that underwent liver transplantation for “status 1”.

*Results: Of 427 articles reviewed, 3 studies comprising 2533 patients (155 underwent LDLT and 2376 DDLT), were included in the meta-analysis. One, 3,5-year patient and graft survival demonstrated no difference between LDLT and DDLT group: 1-year patient survival OR1.51; 95%CI [0.58,1.90]; 1-year graft survival OR 1.19; 95%CI [0.65-2.18]; 3-year patient survival OR 0.97;95%CI [0.52-1.88]; 3-year graft survival OR 1.21 95%CI [0.67-2.16]; 5-year patient survival 0.9; 95%CI [0.37-2.20]; 5-year graft survival OR 1.30; 95%CI [0.57-2.97]. UNOS database search returned only 3 patients that underwent LDLT for ALF compared to 1562 with DDLT precluding comparison.

*Conclusions: One, 3, and 5-year patient and graft survival following LDLT vs DDLT transplantation were not statistically significantly different; however, due to limited number of studies further studies are warranted.

To cite this abstract in AMA style:

Shingina A, Ziogas IA, Vutien P, Uleryk E, Renner E, Bhat MP, Tinmouth J, Kim J. Adult-to-Adult Living Donor Liver Transplantation in Acute Liver Failure – Do Outcomes Justify the Risks? [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/adult-to-adult-living-donor-liver-transplantation-in-acute-liver-failure-do-outcomes-justify-the-risks/. Accessed November 21, 2024.

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