Living-donor liver transplant offers numerous advantages over deceased donor

Washington: A recent study has highlighted the advantages of living-donor liver transplant over deceased-donor.

According to the study, a living-donor liver transplant offers numerous advantages over deceased-donor transplant, including better three-year survival rates for patients and lower costs.

The study published in the journal ‘Annals of Surgery’, highlights living donation as a viable, if not preferable, option for more than 14,000 people currently on the waiting list, as well as many more who never qualify to be on the list under current allocation rules.

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About 8,000 liver transplants are performed each year, according to the Organ Procurement & Transplantation Network, and living-donor liver transplant comprises less than five per cent of that total.

Additionally, about 25 per cent of people on the waiting list die each year waiting for a transplant, and those who eventually receive a transplant often have a lengthy period on the waiting list, resulting in poorer health at the time of transplant.

“The consequences for patients on the waiting list can mean the difference between life and death because the longer they are waiting, the sicker they become. Living-donor liver transplants, in tandem with deceased-donor liver transplants, represents an opportunity to significantly decrease the risk of wait-list mortality, and gives us the ability to transplant a person sooner,” said Abhinav Humar, lead author of the study.

The retrospective review of 245 adult living-donor liver transplants and 592 deceased-donor liver transplants performed over the last 10 years compared survival rates and other outcomes such as recovery times, complications, costs, and resource utilisation. The patients were followed for at least two years post-transplant.Of those comparisons, three-year patient survival outcomes were superior in living-donor liver transplant recipients- 86 per cent versus 80 per cent.

Living-donor liver transplant recipients overall had about a five per cent survival advantage over deceased-donor recipients.

Patients who received a liver from a living donor had a hospital stay of 11 days as compared to 13 days for those who received a liver from a deceased donor, had less likelihood of intraoperative blood transfusion (53 per cent compared to 78 per cent) and less likelihood of the need for post-transplant dialysis (1.6 per cent versus 7.4 per cent). Hospital costs related to transplant also were 29.5 per cent lower for living donor recipients. For the living-liver donor, there were no mortalities observed, and the overall complication rate was 20 per cent.

“Living-donor liver transplant should be considered the first and best option for most patients with liver disease,” Humar said. “It is not only an option for those on the waiting list but could perhaps offset the fact that not everyone who may benefit from transplant qualifies to receive a deceased-donor transplant based on today’s current rules of allocation.”

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