Living Donor and Deceased Donor Liver Transplantation for Autoimmune and Cholestatic Liver Diseases-An Analysis of the UNOS Database

Randeep Kashyap, Saman Safadjou, Rui Chen, Parvez Mantry, Rajeev Sharma, Vrishali Patil, Manoj Maloo, Charlotte Ryan, Carlos Marroquin, Christopher Barry, Gopal Ramaraju, Benedict Maliakkal, Mark Orloff

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Abstract

Introduction: Autoimmune hepatitis and cholestatic liver diseases have more favorable outcomes after liver transplantation as compared to viral hepatitis and alcoholic liver diseases. However, there are only few reports comparing outcomes of both living donor liver transplants (LDLT) and deceased donor liver transplants (DDLT) for these conditions. Aim: We aim to study the survival outcomes of patients undergoing LT for autoimmune and cholestatic diseases and to identify possible risk factors influencing survival. Survival outcomes for LDLT vs. DDLT are also to be compared for these diseases. Patients and Methods: A retrospective analysis of the UNOS database for patients transplanted between February 2002 until October 2006 for AIH, PSC, and PBC was performed. Survival outcomes for LDLT and DDLT patients were analyzed and factors influencing survival were identified. Results: Among all recipients the estimated patient survival at 1, 3, and 5 years for LDLT was 95.5%, 93.6%,and 92.5% and for DDLT was 90.9%, 86.5%, and 84.9%, respectively (p=0.002). The estimated graft survival at 1, 3, and 5 years for LDLT was 87.9%, 85.4%, and 84.3% and for DDLT 85.9%, 80.3%, and 78.6%, respectively (p=0.123). On multivariate proportional hazard regression analysis after adjusting for age and MELD score, the effect of donor type was not found to be significant. Conclusion: The overall survival outcomes of LDLT were similar to DDLT in our patients with autoimmune and cholestatic liver diseases. It appears from our study that after adjusting for age and MELD score donor type does not significantly affect the outcome.

Original languageEnglish (US)
Pages (from-to)1362-1369
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume14
Issue number9
DOIs
StatePublished - Jul 9 2010

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Living Donors
Liver Transplantation
Liver Diseases
Tissue Donors
Databases
Transplants
Liver
Survival
Insemination, Artificial, Homologous
Autoimmune Hepatitis
Alcoholic Liver Diseases
Graft Survival
Hepatitis
Autoimmune Diseases
Regression Analysis
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

Cite this

Kashyap, Randeep ; Safadjou, Saman ; Chen, Rui ; Mantry, Parvez ; Sharma, Rajeev ; Patil, Vrishali ; Maloo, Manoj ; Ryan, Charlotte ; Marroquin, Carlos ; Barry, Christopher ; Ramaraju, Gopal ; Maliakkal, Benedict ; Orloff, Mark. / Living Donor and Deceased Donor Liver Transplantation for Autoimmune and Cholestatic Liver Diseases-An Analysis of the UNOS Database. In: Journal of Gastrointestinal Surgery. 2010 ; Vol. 14, No. 9. pp. 1362-1369.
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title = "Living Donor and Deceased Donor Liver Transplantation for Autoimmune and Cholestatic Liver Diseases-An Analysis of the UNOS Database",
abstract = "Introduction: Autoimmune hepatitis and cholestatic liver diseases have more favorable outcomes after liver transplantation as compared to viral hepatitis and alcoholic liver diseases. However, there are only few reports comparing outcomes of both living donor liver transplants (LDLT) and deceased donor liver transplants (DDLT) for these conditions. Aim: We aim to study the survival outcomes of patients undergoing LT for autoimmune and cholestatic diseases and to identify possible risk factors influencing survival. Survival outcomes for LDLT vs. DDLT are also to be compared for these diseases. Patients and Methods: A retrospective analysis of the UNOS database for patients transplanted between February 2002 until October 2006 for AIH, PSC, and PBC was performed. Survival outcomes for LDLT and DDLT patients were analyzed and factors influencing survival were identified. Results: Among all recipients the estimated patient survival at 1, 3, and 5 years for LDLT was 95.5{\%}, 93.6{\%},and 92.5{\%} and for DDLT was 90.9{\%}, 86.5{\%}, and 84.9{\%}, respectively (p=0.002). The estimated graft survival at 1, 3, and 5 years for LDLT was 87.9{\%}, 85.4{\%}, and 84.3{\%} and for DDLT 85.9{\%}, 80.3{\%}, and 78.6{\%}, respectively (p=0.123). On multivariate proportional hazard regression analysis after adjusting for age and MELD score, the effect of donor type was not found to be significant. Conclusion: The overall survival outcomes of LDLT were similar to DDLT in our patients with autoimmune and cholestatic liver diseases. It appears from our study that after adjusting for age and MELD score donor type does not significantly affect the outcome.",
author = "Randeep Kashyap and Saman Safadjou and Rui Chen and Parvez Mantry and Rajeev Sharma and Vrishali Patil and Manoj Maloo and Charlotte Ryan and Carlos Marroquin and Christopher Barry and Gopal Ramaraju and Benedict Maliakkal and Mark Orloff",
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Kashyap, R, Safadjou, S, Chen, R, Mantry, P, Sharma, R, Patil, V, Maloo, M, Ryan, C, Marroquin, C, Barry, C, Ramaraju, G, Maliakkal, B & Orloff, M 2010, 'Living Donor and Deceased Donor Liver Transplantation for Autoimmune and Cholestatic Liver Diseases-An Analysis of the UNOS Database', Journal of Gastrointestinal Surgery, vol. 14, no. 9, pp. 1362-1369. https://doi.org/10.1007/s11605-010-1256-1

Living Donor and Deceased Donor Liver Transplantation for Autoimmune and Cholestatic Liver Diseases-An Analysis of the UNOS Database. / Kashyap, Randeep; Safadjou, Saman; Chen, Rui; Mantry, Parvez; Sharma, Rajeev; Patil, Vrishali; Maloo, Manoj; Ryan, Charlotte; Marroquin, Carlos; Barry, Christopher; Ramaraju, Gopal; Maliakkal, Benedict; Orloff, Mark.

In: Journal of Gastrointestinal Surgery, Vol. 14, No. 9, 09.07.2010, p. 1362-1369.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Living Donor and Deceased Donor Liver Transplantation for Autoimmune and Cholestatic Liver Diseases-An Analysis of the UNOS Database

AU - Kashyap, Randeep

AU - Safadjou, Saman

AU - Chen, Rui

AU - Mantry, Parvez

AU - Sharma, Rajeev

AU - Patil, Vrishali

AU - Maloo, Manoj

AU - Ryan, Charlotte

AU - Marroquin, Carlos

AU - Barry, Christopher

AU - Ramaraju, Gopal

AU - Maliakkal, Benedict

AU - Orloff, Mark

PY - 2010/7/9

Y1 - 2010/7/9

N2 - Introduction: Autoimmune hepatitis and cholestatic liver diseases have more favorable outcomes after liver transplantation as compared to viral hepatitis and alcoholic liver diseases. However, there are only few reports comparing outcomes of both living donor liver transplants (LDLT) and deceased donor liver transplants (DDLT) for these conditions. Aim: We aim to study the survival outcomes of patients undergoing LT for autoimmune and cholestatic diseases and to identify possible risk factors influencing survival. Survival outcomes for LDLT vs. DDLT are also to be compared for these diseases. Patients and Methods: A retrospective analysis of the UNOS database for patients transplanted between February 2002 until October 2006 for AIH, PSC, and PBC was performed. Survival outcomes for LDLT and DDLT patients were analyzed and factors influencing survival were identified. Results: Among all recipients the estimated patient survival at 1, 3, and 5 years for LDLT was 95.5%, 93.6%,and 92.5% and for DDLT was 90.9%, 86.5%, and 84.9%, respectively (p=0.002). The estimated graft survival at 1, 3, and 5 years for LDLT was 87.9%, 85.4%, and 84.3% and for DDLT 85.9%, 80.3%, and 78.6%, respectively (p=0.123). On multivariate proportional hazard regression analysis after adjusting for age and MELD score, the effect of donor type was not found to be significant. Conclusion: The overall survival outcomes of LDLT were similar to DDLT in our patients with autoimmune and cholestatic liver diseases. It appears from our study that after adjusting for age and MELD score donor type does not significantly affect the outcome.

AB - Introduction: Autoimmune hepatitis and cholestatic liver diseases have more favorable outcomes after liver transplantation as compared to viral hepatitis and alcoholic liver diseases. However, there are only few reports comparing outcomes of both living donor liver transplants (LDLT) and deceased donor liver transplants (DDLT) for these conditions. Aim: We aim to study the survival outcomes of patients undergoing LT for autoimmune and cholestatic diseases and to identify possible risk factors influencing survival. Survival outcomes for LDLT vs. DDLT are also to be compared for these diseases. Patients and Methods: A retrospective analysis of the UNOS database for patients transplanted between February 2002 until October 2006 for AIH, PSC, and PBC was performed. Survival outcomes for LDLT and DDLT patients were analyzed and factors influencing survival were identified. Results: Among all recipients the estimated patient survival at 1, 3, and 5 years for LDLT was 95.5%, 93.6%,and 92.5% and for DDLT was 90.9%, 86.5%, and 84.9%, respectively (p=0.002). The estimated graft survival at 1, 3, and 5 years for LDLT was 87.9%, 85.4%, and 84.3% and for DDLT 85.9%, 80.3%, and 78.6%, respectively (p=0.123). On multivariate proportional hazard regression analysis after adjusting for age and MELD score, the effect of donor type was not found to be significant. Conclusion: The overall survival outcomes of LDLT were similar to DDLT in our patients with autoimmune and cholestatic liver diseases. It appears from our study that after adjusting for age and MELD score donor type does not significantly affect the outcome.

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DO - 10.1007/s11605-010-1256-1

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