Non-alcoholic steatohepatitis (NASH) is an increasingly common indication for liver transplantation in North America. In the context of organ scarcity and significant waitlist mortality, our institution has routinely performed living donor liver transplantation (LDLT) for end-stage liver disease from NASH since 2001. We sought to examine our institutional experience with LDLT for NASH and make comparisons to deceased donor liver transplantation (DDLT) performed during the same era.

Methods:

All DDLT and LDLT transplants performed for NASH-related liver disease from 2000-2014 were included in the study. Recipient characteristics, perioperative outcomes, and long term patient and graft survival were compared between groups.

There were 141 DDLT and 53 LDLT transplants for NASH performed during the study period. Pre-operative MELD score was higher in the DDLT population (21.8 vs. 18.1, p = 0.02). There were no differences between groups in 30 day patient mortality, 30 day graft loss, or significant post-operative complications. LDLT patients had a significantly shorter post-transplant hospitalization (16.7 vs. 27.3, p = 0.03). Five year actuarial patient and graft survival were similar between groups.

Conclusions:

Compared to DDLT, LDLT is similarly safe and effective for well-selected patients with NASH-related liver disease. LDLT allows patients with NASH to undergo transplantation at an earlier stage in their illness with shorter hospitalizations and the potential for decreased resource utilization.

CITATION INFORMATION: Barbas A, Goldaracena N, Dib M, Marquez M, Sapisochin G, Al-Adra D, McGilvray I, Cattral M, Greig P, Grant D. Live Donor Liver Transplantation for NASH: The Toronto Experience. Am J Transplant. 2016;16 (suppl 3).

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