Adult 10-year survivors after liver transplantation: a single-institution experience over 40 years.

Abstract

Liver transplantation (LT) represents the best cure for several acute and chronic liver diseases. Several studies reported excellent mid-term survivals after LT. However, lesser evidence has been reported on very long (10- and 20-year) follow-up results. This study aims to analyze the monocentric LT experience of the Sapienza University of Rome to identify the pre-operatively available parameters limiting a 10-year post-transplant survival. A total of 491 patients transplanted between 1982 and 2012 were enrolled. The cohort was split into two groups, namely the Short Surviving Group (< 10 years; n = 228, 46.4%) and the Long Surviving Group (≥ 10 years; n = 263, 53.6%). Several differences were reported between the two groups regarding initial liver function, surgical techniques adopted, and immunosuppression. Four variables emerged as statistically relevant as independent risk factors for not reaching at least 10 years of follow-up: recipient age (OR = 1.02; P = 0.01), donor age (OR = 1.01; P = 0.03), being transplanted during the eighties (OR = 6.46; P < 0.0001) and nineties (OR = 2.63; P < 0.0001), and the UNOS status 1-2A (OR = 2.62; P < 0.0001). LT confirms to be an extraordinary therapy for several severe liver diseases, consenting to reach in half of the transplanted cases even more than 20 years of follow-up. The initial liver function and the donor and recipient ages are relevant in impacting long-term survival after transplantation. A broad commitment from many professional groups, including surgeons, hepatologists, and anesthesiologists, is necessary. The achievement of excellent results in terms of long-term survival is proof of the effectiveness of this multidisciplinary collaboration.

• Authors: Quirino Lai, Gianluca Mennini, Stefano Ginanni Corradini, Flaminia Ferri, Stefano Fonte, Francesco Pugliese, Manuela Merli, Massimo Rossi
• Journal: Updates in surgery (Updates Surg) Vol. 75 Issue 7 Pg. 1961-1970 (Oct 2023) ISSN: 2038-3312 [Electronic] Italy
• PMID: 37498485 (Publication Type: Journal Article)
• Copyright: © 2023. The Author(s).

Topics

• Humans
• Adult
• Liver Transplantation (adverse effects)
• Tissue Donors
• Risk Factors
• Graft Survival
• Survivors
• Liver Diseases
• Retrospective Studies