Clinical

Living donor liver transplant yields better survival than deceased donor

Last Updated: 2008-01-07 16:07:14 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Compared to waiting for a deceased donor, use of liver from a living donor leads to reduced mortality, according to investigators.

"Our study confirms that the practice of living donor liver transplantation provides considerable reduction in risk of pre-transplant death to liver transplant candidates," lead researcher Dr. Carl Berg told Reuters Health.

Dr. Berg, of the University of Virginia, Charlottesville and colleagues analyzed data on 807 potential living donor recipients. They report their findings in the December issue of Gastroenterology

After a median follow-up of 4.4 years, 638 had undergone liver transplant -- 389 from a living donor and 249 from a deceased donor. Ninety-nine died without transplantation and 70 were awaiting transplantation at last follow-up.

Compared to those with a deceased donor, recipients from a living donor had an adjusted mortality hazard ratio of 0.56.

In addition, the researchers determined that as centers performed more than 20 living transplants and hence gained greater expertise, the mortality hazard ratio fell to 0.35.

This reduction in transplant candidate mortality, write the investigators, "must be balanced against the risks undertaken by the living donors themselves." One report indicated that as many as 38% of donors may experience complications.

Nevertheless, concluded Dr. Berg, "the quantification of this risk reduction may now allow families to more concretely balance the benefits to the living donor liver transplant recipient with the theoretical risks to the living donor."

Gastroenterology 2007;133:1806-1813.