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|
|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 December 12, 2019.
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