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OPTN/SRTR 2023 Annual Data Report: Liver.

Allison J Kwong¹, W Ray Kim², John R Lake³

¹Division of Gastroenterology and Hepatology, Stanford University, Stanford, CA.

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons

|February 13, 2025

Summary

In 2023, a record 10,659 liver transplants were performed in the US, driven by expanded donor criteria and new scoring systems. Despite progress, disparities in transplant rates and pretransplant mortality persist between sexes.

Keywords:

Liver transplantation liver donation outcomes waiting list

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Human Liver Spheroids from Peripheral Blood for Liver Disease Studies

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Area of Science:

Hepatology
Transplant Surgery
Public Health

Background:

Liver transplantation is a critical treatment for end-stage liver disease.
Donor organ availability and allocation systems significantly impact transplant outcomes.
Addressing disparities in access to care is a key challenge in transplantation.

Purpose of the Study:

To report the 2023 national liver transplant statistics in the United States.
To analyze trends in donor utilization, including Donation after Circulatory Death (DCD) and living donation.
To evaluate the impact of updated Model for End-Stage Liver Disease (MELD) 3.0 and Pediatric End-Stage Liver Disease (PELD) scoring systems on transplant equity.

Main Methods:

Analysis of national liver transplant data from 2023.
Review of donor characteristics, including age and DCD status.
Assessment of transplant rates and pretransplant mortality by sex and updated MELD/PELD scores.

Main Results:

A record 10,659 liver transplants were performed, with growth attributed to older and DCD donors.
The nonuse rate of recovered livers decreased to 9.7%, with 16.7% of recipients accepting DCD livers.
The MELD 3.0/PELD update narrowed the sex disparity in deceased donor liver transplant rates, but males still received transplants at higher rates.

Conclusions:

The increase in liver transplants highlights advancements in organ recovery and utilization.
Updated MELD/PELD scoring systems show promise in reducing sex-based disparities in liver transplant allocation.
Continued efforts are needed to address remaining inequities in pretransplant mortality and transplant rates for female candidates.