Association Between Distance to the Transplant Center and Survival Following Living Donor Liver Transplantation

To determine whether the distance from home to our transplant center affects posttransplant survival in patients undergoing living donor liver transplantation.

Data from 301 adult patients who underwent primary living donor liver transplantation at our center between January 2000 and July 2023 were retrospectively reviewed. The patients were divided into three groups according to the distance of their homes from our center: Group 1, 0-9 miles (n = 104); Group 2, 10-40 miles (n = 121); and Group 3, > 40 miles (n = 76).

Graft and patient survival rates were significantly lower in Group 3 than in Group 1 (p = 0.010 and p = 0.004, respectively). Multivariate analysis showed that living > 40 miles from our transplant center was independently associated with worse patient survival (p = 0.025). Furthermore, conditional survival analysis revealed that living > 40 miles from our transplant center was associated with impaired 3-year patient survival. Subgroup analysis of Group 3 revealed that patients living > 40 miles to the nearest transplant center or university hospital had significantly lower 3-year conditional survival rates than those of patients living < 40 miles from the nearest facility (p = 0.011).

Greater distances to the transplant center may negatively affect posttransplant outcomes. Therefore, patients who have undergone living donor liver transplantation and who reside in areas far from specialized medical services should be monitored with caution.