Background: SBP is a life threatening complication of end stage liver disease. Reports indicate a 40-50% one year mortality rate in patients who experience SBP and do not receive a liver transplant. We examined the efficacy of live donor liver transplantation (LDLT) in patients with SBP.

Methods: We performed a retrospective review of 236 LDLT recipients at our center between 2000 and 2013. Patients were stratified by presence of pre-transplant SBP; demographics, patient survival, MELD scores, and diagnosis were compared using SPSS software. Log rank rests were used to identify differences in Kaplan Meier Survival curves. P< 0.05 was considered significant.

Results: The cohort consisted of 168 males and 68 females. Hepatitis C was the most common diagnosis (38.4%) followed by alcohol (13.3%) and primary sclerosing cholangitis (12.5%). SBP occurred in 55 patients (39 men, 16 women); causes of ESLD were similar in both groups. The demographics and survival data for patients with and without pre-transplant SBP are shown in Table 1 and Figure 1.

Conclusions: Patients with history of SBP who receive LDLTs demonstrate an 87% 1 year survival rate and a 70% 10 year survival rate. These rates are comparable to those seen in LDLT recipients without history of SBP and improved compared to reported results in SBP patients who are not transplanted. Patients are at increased risk of death following episodes of SBP and should be considered for LDLT as soon as possible following resolution of the acute phase. Since SBP does not directly contribute to MELD score, prompt performance of LDLT provides superior survival benefit compared to remaining on the waitlist.

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