OPTN/SRTR 2011 Annual Data Report: Liver

Authors

  • W. R. Kim,

    1. Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
    2. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
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  • P. G. Stock,

    1. Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
    2. Department of Surgery, University of California, San Francisco, California
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  • J. M. Smith,

    1. Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
    2. Department of Pediatrics, University of Washington, Seattle, Washington
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  • J. K. Heimbach,

    1. William J. von Liebig Transplant Center, Mayo Clinic College of Medicine, Rochester, Minnesota
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  • M. A. Skeans,

    1. Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
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  • E. B. Edwards,

    1. Organ Procurement and Transplantation Network, Richmond, Virginia
    2. United Network for Organ Sharing, Richmond, Virginia
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  • A. M. Harper,

    1. Organ Procurement and Transplantation Network, Richmond, Virginia
    2. United Network for Organ Sharing, Richmond, Virginia
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  • J. J. Snyder,

    1. Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
    2. Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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  • A. K. Israni,

    1. Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
    2. Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
    3. Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, Minnesota
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  • B. L. Kasiske

    1. Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
    2. Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, Minnesota
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Abstract

ABSTRACT  The current liver allocation system, introduced in 2002, decreased the importance of waiting time for allocation priorities; the number of active wait-listed candidates and median waiting times were immediately reduced. However, the total number of adult wait-listed candidates has increased since 2002, and median waiting time has increased since 2006. Pretransplant mortality rates have been stable, but the number of candidates withdrawn from the list as being too sick to undergo transplant nearly doubled between 2009 and 2011. Deceased donation rates have remained stable, with an increasing proportion of expanded criteria donors. Living donation has decreased over the past 10 years. Transplant outcomes remain robust, with continuously improving graft survival rates for deceased donor, living donor, and donation after circulatory death livers. Numbers of new and prevalent pediatric candidates on the waiting list have decreased. Pediatric pretransplant mortality has decreased, most dramatically for candidates aged less than 1 year. The transplant rate has increased since 2002, and is highest in candidates aged less than 1 year. Graft survival continues to improve for pediatric recipients of deceased donor and living donor livers. Incidence of acute rejections increases with time after transplant. Posttransplant lymphoproliferative disorder remains an important concern in pediatric recipients.

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