icon-folder.gif   Conference Reports for NATAP  
  38th Annual Meeting of the European Association for the Study of the Liver
Istanbul, Turkey. March 28-April 1, 2003
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  P.J. Thuluvath, H.Y. Yoo, Department Of Medicine, The Johns Hopkins University School Of Medicine, Baltimore, MD, USA
Anecdotal experience also shows that LDLT recipients with HCV may have a poor outcome. Objective: To analyze the outcomes of LDLT and compare the results to a matched population who received cadaver liver transplant (CLT) using UNOS data. Patients & Methods: For each LDLT recipients (n=764), two CLT recipients (case-controls, n=1470), matched for age, sex and diagnosis, were selected from the UNOS data. Results: As per study design, both groups had similar age, sex and etiology. 2.5% (n=19) of the recipients had previous liver transplantation, and there was no multi-organ transplantation along with LDLT. Recipients of LDLT had more stable liver disease as shown by fewer patients with UNOS status 1, in ICU or with life support. Creatinine and cold ischemia time were higher in the CLT groups. Incidence of primary graft non-function and 2-year Kaplan-Meier survival was similar in both groups (79.0% in LDLT vs. 80.7% in case-controls, p=0.56). 2-yr graft survival was lower in LDLT (64.4% vs. 73.3%, p <0.001). Cox regression (after adjusting for confounding variables) showed a significantly lower graft (HR 1.6) survival in LDLT. HCV positive LDLT recipients showed lowest graft survival when compared to non-HCV LDLT recipients or HCV patients who received CLT. Conclusion: LDLT recipients are less sick than CLT recipients. Although 2-year patient survival in LDLT is similar to a matched population who received CLT, 2-year graft survival was significantly lower in LDLT recipients. HCV recipients who had LDLT had a poor survival compared to either CLT recipients with HCV or non-HCV LDLT recipients.