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Article first published online: 27 JUN 2011
Copyright © 2011 American Association for the Study of Liver Diseases
Volume 17, Issue 7, pages 789–797, July 2011
How to Cite
Olthoff, K. M., Abecassis, M. M., Emond, J. C., Kam, I., Merion, R. M., Gillespie, B. W., Tong, L. and the Adult-to-Adult Living Donor Liver Transplantation Cohort Study Group (2011), Outcomes of adult living donor liver transplantation: Comparison of the adult-to-adult living donor liver transplantation cohort study and the national experience. Liver Transpl, 17: 789–797. doi: 10.1002/lt.22288
This study was presented in part at the American Transplant Congress, Toronto, Canada, June 2008.
This is publication 15 of the Adult-to-Adult Living Donor Liver Transplantation Cohort Study.
Supplemental data included in this article were supplied by the Arbor Research Collaborative for Health as the contractor for the Scientific Registry of Transplant Recipients. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy of or interpretation by the Scientific Registry of Transplant Recipients or the US Government.
This study was supported in part by the National Institutes of Health through the National Institute of Diabetes and Digestive and Kidney Diseases (grants U01-DK62536, U01-DK62444, U01-DK62467, U01-DK62483, U01-DK62484, U01-DK62494, U01-DK62496, U01-DK62498, U01-DK62505, and U01-DK62531), by the American Society of Transplant Surgeons, and by the US Department of Health and Human Services through the Health Resources and Services Administration.
- Issue published online: 27 JUN 2011
- Article first published online: 27 JUN 2011
- Accepted manuscript online: 25 FEB 2011 08:57AM EST
- Manuscript Accepted: 13 FEB 2011
- Manuscript Received: 27 OCT 2010
The study objectives were to determine whether the findings of the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) reflect the U.S. national experience and to define risk factors for patient mortality and graft loss in living donor liver transplantation (LDLT). A2ALL previously identified risk factors for mortality after LDLT, which included early center experience, older recipient age, and longer cold ischemia time. LDLT procedures at 9 A2ALL centers (n = 702) and 67 non-A2ALL centers (n = 1664) from January 1998 through December 2007 in the Scientific Registry of Transplant Recipients database were analyzed. Potential predictors of time from transplantation to death or graft failure were tested using Cox regression. No significant difference in overall mortality between A2ALL and non-A2ALL centers was found. Higher hazard ratios (HRs) were associated with donor age (HR = 1.13 per 10 years, P = 0.0002), recipient age (HR = 1.20 per 10 years, P = 0.0003), serum creatinine levels (HR = 1.52 per loge unit increase, P < 0.0001), hepatocellular carcinoma (HR = 2.12, P<0.0001) or hepatitis C virus (HR = 1.18, P = 0.026), intensive care unit stay (HR = 2.52, P< 0.0001) or hospitalization (HR = 1.62, P < 0.0001) versus home, earlier center experience (LDLT case number 15: HR = 1.61, P < 0.0001, and a cold ischemia time >4.5 hours (HR = 1.79, P = 0.0006). Except for center experience, risk factor effects between A2ALL and non-A2ALL centers were not significantly different. Variables associated with graft loss were identified and showed similar trends. In conclusion, mortality and graft loss risk factors were similar in A2ALL and non-A2ALL centers. These analyses demonstrate that findings from the A2ALL consortium are relevant to other centers in the U.S. performing LDLT, and conclusions and recommendations from A2ALL may help to guide clinical decision making. Liver Transpl 17:789-797, 2011. © 2011 AASLD.