Comparative analysis of outcomes in living and deceased donor liver transplants for primary sclerosing cholangitis

Randeep Kashyap, Parvez Mantry, Rajeev Sharma, Manoj K. Maloo, Saman Safadjou, Yanjie Qi, Ashokkumar Jain, Benedict Maliakkal, Charlotte Ryan, Mark Orloff

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Introduction Primary sclerosing cholangitits (PSC) is a progressive fibrosing cholangiopathy eventually leading to end-stage liver disease (ESLD). While literature for deceased donor liver transplantation (DDLT) for PSC abounds, only a few reports describe live donor liver transplant (LDLT) in the setting of PSC. We present a single-center experience on survival outcomes and disease recurrence for LDLT and DDLT for ESLD secondary to PSC. Aim The aim of this study was to analyze survival outcomes and disease recurrence for LDLT and DDLT for ESLD secondary to PSC. Patients and Methods A retrospective review of 58 primary liver transplants for PSC-associated ESLD, performed between May 1995 and January 2007, was done. Patients were divided into two groups based on donor status. Group 1 (n = 14) patients received grafts from living donors, while group 2 (n = 44) patients received grafts from deceased donors. An analysis of survival outcomes and disease recurrence was performed. Recurrence was confirmed based on radiological and histological criteria. Results Recurrence of PSC was observed in four patients in LDLT group and seven in DDLT group. Retransplantation was required in one patient in LDLT group and nine patients in DDLT group. One patient (7%) among LDLT and six patients (14%) among DDLT died. The difference in patient and graft survival was not statistically significant between the two groups (patient survival, p = 0.60; graft survival, p = 0.24). Conclusion This study demonstrates equivalent survival outcomes between LDLT and DDLT for PSC; however, the rate of recurrence may be higher in patients undergoing LDLT.

Original languageEnglish (US)
Pages (from-to)1480-1486
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume13
Issue number8
DOIs
StatePublished - Jul 1 2009

Fingerprint

Sclerosing Cholangitis
Living Donors
Tissue Donors
Transplants
Liver
Liver Transplantation
End Stage Liver Disease
Recurrence
Graft Survival
Survival Analysis
Survival

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

Cite this

Kashyap, Randeep ; Mantry, Parvez ; Sharma, Rajeev ; Maloo, Manoj K. ; Safadjou, Saman ; Qi, Yanjie ; Jain, Ashokkumar ; Maliakkal, Benedict ; Ryan, Charlotte ; Orloff, Mark. / Comparative analysis of outcomes in living and deceased donor liver transplants for primary sclerosing cholangitis. In: Journal of Gastrointestinal Surgery. 2009 ; Vol. 13, No. 8. pp. 1480-1486.
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title = "Comparative analysis of outcomes in living and deceased donor liver transplants for primary sclerosing cholangitis",
abstract = "Introduction Primary sclerosing cholangitits (PSC) is a progressive fibrosing cholangiopathy eventually leading to end-stage liver disease (ESLD). While literature for deceased donor liver transplantation (DDLT) for PSC abounds, only a few reports describe live donor liver transplant (LDLT) in the setting of PSC. We present a single-center experience on survival outcomes and disease recurrence for LDLT and DDLT for ESLD secondary to PSC. Aim The aim of this study was to analyze survival outcomes and disease recurrence for LDLT and DDLT for ESLD secondary to PSC. Patients and Methods A retrospective review of 58 primary liver transplants for PSC-associated ESLD, performed between May 1995 and January 2007, was done. Patients were divided into two groups based on donor status. Group 1 (n = 14) patients received grafts from living donors, while group 2 (n = 44) patients received grafts from deceased donors. An analysis of survival outcomes and disease recurrence was performed. Recurrence was confirmed based on radiological and histological criteria. Results Recurrence of PSC was observed in four patients in LDLT group and seven in DDLT group. Retransplantation was required in one patient in LDLT group and nine patients in DDLT group. One patient (7{\%}) among LDLT and six patients (14{\%}) among DDLT died. The difference in patient and graft survival was not statistically significant between the two groups (patient survival, p = 0.60; graft survival, p = 0.24). Conclusion This study demonstrates equivalent survival outcomes between LDLT and DDLT for PSC; however, the rate of recurrence may be higher in patients undergoing LDLT.",
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Kashyap, R, Mantry, P, Sharma, R, Maloo, MK, Safadjou, S, Qi, Y, Jain, A, Maliakkal, B, Ryan, C & Orloff, M 2009, 'Comparative analysis of outcomes in living and deceased donor liver transplants for primary sclerosing cholangitis', Journal of Gastrointestinal Surgery, vol. 13, no. 8, pp. 1480-1486. https://doi.org/10.1007/s11605-009-0898-3

Comparative analysis of outcomes in living and deceased donor liver transplants for primary sclerosing cholangitis. / Kashyap, Randeep; Mantry, Parvez; Sharma, Rajeev; Maloo, Manoj K.; Safadjou, Saman; Qi, Yanjie; Jain, Ashokkumar; Maliakkal, Benedict; Ryan, Charlotte; Orloff, Mark.

In: Journal of Gastrointestinal Surgery, Vol. 13, No. 8, 01.07.2009, p. 1480-1486.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparative analysis of outcomes in living and deceased donor liver transplants for primary sclerosing cholangitis

AU - Kashyap, Randeep

AU - Mantry, Parvez

AU - Sharma, Rajeev

AU - Maloo, Manoj K.

AU - Safadjou, Saman

AU - Qi, Yanjie

AU - Jain, Ashokkumar

AU - Maliakkal, Benedict

AU - Ryan, Charlotte

AU - Orloff, Mark

PY - 2009/7/1

Y1 - 2009/7/1

N2 - Introduction Primary sclerosing cholangitits (PSC) is a progressive fibrosing cholangiopathy eventually leading to end-stage liver disease (ESLD). While literature for deceased donor liver transplantation (DDLT) for PSC abounds, only a few reports describe live donor liver transplant (LDLT) in the setting of PSC. We present a single-center experience on survival outcomes and disease recurrence for LDLT and DDLT for ESLD secondary to PSC. Aim The aim of this study was to analyze survival outcomes and disease recurrence for LDLT and DDLT for ESLD secondary to PSC. Patients and Methods A retrospective review of 58 primary liver transplants for PSC-associated ESLD, performed between May 1995 and January 2007, was done. Patients were divided into two groups based on donor status. Group 1 (n = 14) patients received grafts from living donors, while group 2 (n = 44) patients received grafts from deceased donors. An analysis of survival outcomes and disease recurrence was performed. Recurrence was confirmed based on radiological and histological criteria. Results Recurrence of PSC was observed in four patients in LDLT group and seven in DDLT group. Retransplantation was required in one patient in LDLT group and nine patients in DDLT group. One patient (7%) among LDLT and six patients (14%) among DDLT died. The difference in patient and graft survival was not statistically significant between the two groups (patient survival, p = 0.60; graft survival, p = 0.24). Conclusion This study demonstrates equivalent survival outcomes between LDLT and DDLT for PSC; however, the rate of recurrence may be higher in patients undergoing LDLT.

AB - Introduction Primary sclerosing cholangitits (PSC) is a progressive fibrosing cholangiopathy eventually leading to end-stage liver disease (ESLD). While literature for deceased donor liver transplantation (DDLT) for PSC abounds, only a few reports describe live donor liver transplant (LDLT) in the setting of PSC. We present a single-center experience on survival outcomes and disease recurrence for LDLT and DDLT for ESLD secondary to PSC. Aim The aim of this study was to analyze survival outcomes and disease recurrence for LDLT and DDLT for ESLD secondary to PSC. Patients and Methods A retrospective review of 58 primary liver transplants for PSC-associated ESLD, performed between May 1995 and January 2007, was done. Patients were divided into two groups based on donor status. Group 1 (n = 14) patients received grafts from living donors, while group 2 (n = 44) patients received grafts from deceased donors. An analysis of survival outcomes and disease recurrence was performed. Recurrence was confirmed based on radiological and histological criteria. Results Recurrence of PSC was observed in four patients in LDLT group and seven in DDLT group. Retransplantation was required in one patient in LDLT group and nine patients in DDLT group. One patient (7%) among LDLT and six patients (14%) among DDLT died. The difference in patient and graft survival was not statistically significant between the two groups (patient survival, p = 0.60; graft survival, p = 0.24). Conclusion This study demonstrates equivalent survival outcomes between LDLT and DDLT for PSC; however, the rate of recurrence may be higher in patients undergoing LDLT.

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