Outcomes of Living Versus Deceased Donor Liver Transplantation for Acute Liver Failure in the United States

Abstract Clinical outcomes for living donor liver transplantation (LDLT) for acute liver failure (ALF) in the United States remain to be determined. To address this gap in knowledge, we examined post–liver transplantation outcomes of adults with ALF undergoing LDLT and deceased donor liver transplan...

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Bibliographic Details
Published inTransplantation proceedings Vol. 46; no. 1; pp. 219 - 224
Main Authors Urrunaga, N.H, Rachakonda, V.P, Magder, L.S, Mindikoglu, A.L
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 2014
Subjects
Adult
Female
Graft Survival
Humans
Liver Failure, Acute - mortality
Liver Failure, Acute - surgery
Liver Transplantation - methods
Liver Transplantation - statistics & numerical data
Living Donors
Male
Middle Aged
Necrosis - physiopathology
Surgery
Survival Rate
Time Factors
Treatment Outcome
United States
Young Adult
United States
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Summary:Abstract Clinical outcomes for living donor liver transplantation (LDLT) for acute liver failure (ALF) in the United States remain to be determined. To address this gap in knowledge, we examined post–liver transplantation outcomes of adults with ALF undergoing LDLT and deceased donor liver transplantation (DDLT) in the United States. We analyzed Organ and Procurement and Transplantation Network data for adults with ALF who were listed for liver transplantation as status 1 or 1A and who underwent LDLT (N = 21) or DDLT (N = 2316) between October 1987 and April 2011. We found no strong evidence that the survival probabilities for adults with ALF who underwent LDLT were inferior to those who underwent DDLT ( P  = .764). In adults with ALF who underwent LDLT, 1- and 5-year survival probabilities were both 71%; for DDLT these probabilities were 79% and 71%, respectively. In adults with ALF, 1- and 5-year liver graft survival probabilities, respectively, were 62% and 57% for LDLT, and 74% and 66% for DDLT. In these series of adults with ALF who were listed as status 1 or 1A, patient and graft survival rates for LDLT were similar to those for DDLT. Our findings suggest that if deceased donor livers are unavailable, LDLT is an acceptable option in experienced centers for adults with ALF.
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ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2013.08.111