Adult Orthotopic Liver Tx in UK & Ireland Between 1994 and 2005.

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Transplantation. 2007 Sep 15;84(5):572-579.

Adult Orthotopic Liver

Transplantation in the United Kingdom and Ireland Between 1994

and 2005.

van der Meulen

JH, Lewsey JD, Dawwas MF, Copley LP; on behalf of the UK and Ireland Liver Transplant Audit.

 Health Services

Research Unit, Department of Public Health and Policy, London

School of Hygiene and Tropical

Medicine, London, United

Kingdom. Clinical

Effectiveness Unit, The Royal College

of Surgeons of England,

London, United Kingdom. Hepatobiliary and Liver

Transplant Unit, Addenbrookeʼs Hospital, Cambridge

University Hospital,

NHS Foundation Trust, Cambridge, United

Kingdom.

BACKGROUND.: The UK

and Ireland Liver Transplant Audit collects information on all liver

transplantations that are carried out in both countries. In

this paper, we describe these transplantations and their outcomes in adult

patients according to primary liver disease diagnosis, type of transplantation

and period. METHODS.: A prospective cohort study of

7906 orthotopic liver transplantations carried out

between April 1994 and June 2005 in the United

Kingdom and Ireland. Multivariable logistic regression was used to investigate

improvements in mortality according to period of transplantation adjusted for

recipient and donor characteristics. RESULTS.: A total

of 6,850 transplantations were done in adults (patients 16 years or older). Of these, 836 (12.2%) were first super-urgent procedures

(33.7% men; median age 36 years), and 5,072 (74.0%) first elective procedures

(60.0% men; median age 52 years). The percentage of

patients who received a donor organ with abnormal appearance gradually

increased, especially in patients receiving an elective transplant. Mortality at 90 days after first super-urgent transplant

decreased from 29.6% (95% confidence interval: 23.5% to 36.9%) before October 1, 1996 to 16.0% (11.7% to

21.7%) after October 1, 2002. Considering the same time periods, mortality at 90 days

after first elective transplant decreased from 10.6% (8.9% to 12.7%) to 7.7%

(6.3% to 9.3%). Multivariable analysis demonstrated

that these improvements cannot be explained by changes in the risk profile of

recipients and donors. CONCLUSIONS.: Patients

undergoing a liver transplantation in the most recent years had a better

survival than patients with similar characteristics transplanted 10 years earlier. Posttransplant survival has

improved despite a deteriorating quality of donor organs.  PMID: 17876268 [PubMed

- as supplied by publisher]

With love, Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (33) UC 91 - PSC 99 - Tx 6/21 & 6/30/07 @ Baylor in Dallas