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OPTN/SRTR 2019 Annual Data Report: Liver.

A J Kwong1, W R Kim1,2, J R Lake2,3

  • 1Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA.

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|February 17, 2021
PubMed
Summary
This summary is machine-generated.

In 2019, liver transplant policies changed, increasing transplants and improving survival. Wait times decreased for many, and alcohol-related liver disease became a more common transplant reason.

Keywords:
Liver transplantallocationdistributionwaiting list

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Area of Science:

  • Hepatology and Transplant Surgery
  • Public Health Policy
  • Organ Allocation Systems

Background:

  • Significant policy changes impacted liver transplant allocation in 2019, including the Model for End-Stage Liver Disease (MELD) exception points and the National Liver Review Board.
  • The national acuity circle liver distribution policy was briefly implemented before reverting to traditional boundaries.

Purpose of the Study:

  • To analyze the impact of 2019 policy changes on liver transplant waiting lists, registrations, and outcomes.
  • To evaluate trends in liver transplant indications and recipient demographics.

Main Methods:

  • Analysis of national liver transplant data from 2019, focusing on waiting list changes, transplant numbers, and policy implementation.
  • Comparison of transplant rates, waiting times, and patient survival before and after policy modifications.

Main Results:

  • Liver transplant waiting list registrations and performed transplants increased in 2019, with a notable 31% rise in living-donor liver transplants.
  • Median waiting time decreased for candidates with MELD scores of 15-34, potentially linked to policy changes prioritizing non-exception candidates.
  • Hepatitis C as an indication declined, while alcohol-related liver disease and non-alcoholic steatohepatitis increased; graft and patient survival improved despite sicker recipients.

Conclusions:

  • 2019 policy changes appear to have positively influenced liver transplant volume and reduced waiting times for certain patient groups.
  • Shifting indications towards alcohol-related and non-alcoholic steatohepatitis, alongside improved survival in older, sicker patients, highlight evolving transplant landscape.