These authors have contributed equally to this work.
Twenty-Year Longitudinal Follow-Up After Orthotopic Liver Transplantation: A Single-Center Experience of 313 Consecutive Cases
Article first published online: 4 SEP 2013
© Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 13, Issue 9, pages 2384–2394, September 2013
How to Cite
Schoening, W. N., Buescher, N., Rademacher, S., Andreou, A., Kuehn, S., Neuhaus, R., Guckelberger, O., Puhl, G., Seehofer, D. and Neuhaus, P. (2013), Twenty-Year Longitudinal Follow-Up After Orthotopic Liver Transplantation: A Single-Center Experience of 313 Consecutive Cases. American Journal of Transplantation, 13: 2384–2394. doi: 10.1111/ajt.12384
- Issue published online: 4 SEP 2013
- Article first published online: 4 SEP 2013
- Manuscript Accepted: 12 JUN 2013
- Manuscript Revised: 13 MAY 2013
- Manuscript Received: 13 MAR 2013
- Liver transplantation;
- long-term outcome
With excellent short-term survival in liver transplantation (LT), we now focus on long-term outcome and report the first European single-center 20-year survival data. Three hundred thirty-seven LT were performed in 313 patients (09/88–12/92). Impact on long-term outcome was studied and a comparison to life expectancy of matched normal population was performed. A detailed analysis of 20-years follow-up concerning overweight (HBMI), hypertension (HTN), diabetes (HGL), hyperlipidemia (HLIP) and moderately or severely impaired renal function (MIRF, SIRF) is presented. Patient and graft survival at 1, 10, 20 years were 88.4%, 72.7%, 52.5% and 83.7%, 64.7% and 46.6%, respectively. Excluding 1-year mortality, survival in the elderly LT recipients was similar to normal population. Primary indication (p < 0.001), age (p < 0.001), gender (p = 0.017), impaired renal function at 6 months (p < 0.001) and retransplantation (p = 0.034) had significant impact on patient survival. Recurrent disease (21.3%), infection (20.6%) and de novo malignancy (19.9%) were the most common causes of death. Prevalence of HTN (57.3–85.2%, p < 0.001), MIRF (41.8–55.2%, p = 0.01) and HBMI (33.2–45%, p = 0.014) increased throughout follow-up, while prevalence of HLIP (78.0–47.6%, p < 0.001) declined. LT has conquered many barriers to achieve these outstanding long-term results. However, much work is needed to combat recurrent disease and side effects of immunosuppression (IS).