Long-term results after liver transplantation

Area of Science:

• Hepatology
• Transplant Surgery
• Gastroenterology

Background:

• Liver transplantation (OLT) is a definitive treatment for end-stage liver disease.
• Long-term outcomes data are crucial for evaluating OLT efficacy and guiding patient management.
• A single-center analysis provides valuable insights into sustained OLT performance.

Purpose of the Study:

• To evaluate the long-term results of adult OLT performed at a single center over a 15-year period.
• To analyze patient and graft survival rates following OLT and retransplantation.
• To identify main indications for OLT and causes of death post-transplantation.

Main Methods:

• Retrospective analysis of 1365 adult OLTs performed between 1988 and 2002.
• Data collection included patient demographics, indications for OLT, retransplantation details, and survival outcomes.
• Survival rates were calculated at 1, 5, 10, and 15 years post-transplantation.

Main Results:

• The primary indications for OLT were viral-induced cirrhosis (27.1%), alcoholic liver disease (21%), tumors (15.7%), and cholestatic liver disease (14.6%).
• Patient survival rates were 91.4% (1 year), 82.5% (5 years), 74.7% (10 years), and 68.2% (15 years).
• Graft survival rates were 85.8% (1 year), 75.3% (5 years), 67.3% (10 years), and 61.7% (15 years).
• Retransplantation was performed in 9.6% of patients, with 15-year survival of 48.0% after retransplantation.
• Leading causes of death included disease recurrence (32.1%), infections (21.8%), and de novo malignancies (13.5%).

Conclusions:

• This single-center study demonstrates excellent and sustained long-term patient and graft survival following liver transplantation.
• Retransplantation outcomes, while lower, still offer a survival benefit for select patients.
• Continuous monitoring and management of post-OLT complications like infections and malignancies are essential for improving long-term results.