Liver Transplantation in the United States, 1999–2008

Changes in organ allocation policy in 2002 reduced the number of adult patients on the liver transplant waiting list, changed the characteristics of transplant recipients and increased the number of patients receiving simultaneous liver–kidney transplantation (SLK). The number of liver transplants peaked in 2006 and declined marginally in 2007 and 2008. During this period, there was an increase in donor age, the Donor Risk Index, the number of candidates receiving MELD exception scores and the number of recipients with hepatocellular carcinoma. In contrast, there was a decrease in retransplantation rates, and the number of patients receiving grafts from either a living donor or from donation after cardiac death. The proportion of patients with severe obesity, diabetes and renal insufficiency increased during this period. Despite increases in donor and recipient risk factors, there was a trend towards better 1‐year graft and patient survival between 1998 and 2007. Of major concern, however, were considerable regional variations in waiting time and posttransplant survival. The current status of liver transplantation in the United States between 1999 and 2008 was analyzed using SRTR data. In addition to a general summary, we have included a more detailed analysis of liver transplantation for hepatitis C, retransplantation and SLK transplantation.

[1]  J. Kirklin,et al.  Outcomes of Children Bridged to Heart Transplantation With Ventricular Assist Devices: A Multi-Institutional Study , 2006, Circulation.

[2]  O H Frazier,et al.  Use of a continuous-flow device in patients awaiting heart transplantation. , 2007, The New England journal of medicine.

[3]  W Marsh,et al.  Long-Term Survival After Liver Transplantation in 4,000 Consecutive Patients at a Single Center , 2000, Annals of surgery.

[4]  M. Russo,et al.  Despite decreased wait-list times for lung transplantation, lung allocation scores continue to increase. , 2009, Chest.

[5]  C. Sima,et al.  Liver and Intestine Transplantation in the United States, 1996–2005 , 2007, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[6]  D. Schaubel,et al.  Repeat Organ Transplantation in the United States, 1996–2005 , 2007, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[7]  K. McCurry,et al.  Lung Transplantation in the United States, 1998–2007 , 2009, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[8]  J. Chessare,et al.  Organ donation breakthrough collaborative: increasing organ donation through system redesign. , 2006, Critical care nurse.

[9]  Michael John Smith,et al.  The impact of the lung allocation score on short-term transplantation outcomes: a multicenter study. , 2008, The Journal of thoracic and cardiovascular surgery.

[10]  R. Merion,et al.  Liver and Intestine Transplantation in the United States, 1997–2006 , 2008, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[11]  C. Goss,et al.  Lung allocation score for lung transplantation: impact on disease severity and survival. , 2007, Chest.

[12]  C. Merlo,et al.  Impact of advanced age in lung transplantation: an analysis of United Network for Organ Sharing data. , 2009, Journal of the American College of Surgeons.

[13]  T. Therneau,et al.  Hepatic retransplantation in cholestatic liver disease: Impact of the interval to retransplantation on survival and resource utilization , 1999, Hepatology.

[14]  C. Merlo,et al.  Impact of U.S. Lung Allocation Score on survival after lung transplantation. , 2009, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[15]  Harvey S Borovetz,et al.  The National Heart, Lung, and Blood Institute Pediatric Circulatory Support Program. , 2005, Circulation.

[16]  R. Patten,et al.  The effect of ventricular assist devices on post-transplant mortality an analysis of the United network for organ sharing thoracic registry. , 2009, Journal of the American College of Cardiology.

[17]  F L Grover,et al.  Development of the New Lung Allocation System in the United States , 2006, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[18]  P. Thuluvath,et al.  Effect of race on outcome of orthotopic liver transplantation: a cohort study , 2002, The Lancet.

[19]  J. Robins,et al.  Recovery of Information and Adjustment for Dependent Censoring Using Surrogate Markers , 1992 .

[20]  J. Golden,et al.  Impact of the lung allocation score on lung transplantation for pulmonary arterial hypertension. , 2009, American journal of respiratory and critical care medicine.

[21]  B. McCrindle,et al.  Equivalent Outcomes for Pediatric Heart Transplantation Recipients: ABO‐Blood Group Incompatible versus ABO‐Compatible , 2010, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[22]  S. Kumer,et al.  Combined liver–kidney and liver transplantation in patients with renal failure outcomes in the MELD era , 2009, Transplant international : official journal of the European Society for Organ Transplantation.

[23]  B. Meyers,et al.  Strategies to optimize the use of currently available lung donors. , 2004, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[24]  A. Arrington,et al.  Ninety-day mortality and major complications are not affected by use of lung allocation score. , 2008, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[25]  K. Reddy,et al.  Simultaneous Liver–Kidney Transplantation: Evaluation to Decision Making , 2007, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[26]  D. E. Schaubela,et al.  The Survival Benefit of Deceased Donor Liver Transplantation as a Function of Candidate Disease Severity and Donor Quality , 2008 .

[27]  J. Coles,et al.  ABO-incompatible heart transplantation in infants. , 2001, The New England journal of medicine.

[28]  M C Oz,et al.  Long-term use of a left ventricular assist device for end-stage heart failure. , 2001, The New England journal of medicine.

[29]  G N Levine,et al.  Analytical Methods and Database Design: Implications for Transplant Researchers, 2005 , 2006, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[30]  J. Christie,et al.  Effects of lung allocation score on waiting list rankings and transplant procedures. , 2006, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[31]  J. Heimbach,et al.  Liver and Intestine Transplantation in the United States 1998–2007 , 2009, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[32]  T. Kohmoto,et al.  Improved survival after heart transplantation in patients with bridge to transplant in the recent era: a 17-year single-center experience. , 2009, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[33]  S. Keshavjee,et al.  The Effect of Recipient's Age on Lung Transplant Outcome , 2007 .