Long-term outcomes (beyond 5 years) of liver transplant recipients--a transatlantic multicenter study

Palaniyappan, Naaventhan; Peach, Emily; Pearce, Fiona; Dhaliwal, Amritpal; Campos-Varela, Isabel; Cant, Matthew R; Dopazo, Cristina; Trotter, James; Divani-Patel, Sapna; Hatta, Ayiesha AZ; Hopkins, Laurence; Testa, Giuliano; Bilbao, Angela; Kasmani, Zain; Faloon, Sarah; Mirza, Darius F; Klintmalm, Goran B; Bilbao, Itxarone; Asrani, Sumeet K; Rajoriya, Neil; Aravinthan, Aloysious D

Abstract

The long-term (>5y) outcomes following liver transplantation (LT) have not been extensively reported. The aim was to evaluate outcomes of LT recipients who have survived the first 5 years. A multicenter retrospective analysis of prospectively collected data from 3 high volume LT centers (Dallas-USA, Birmingham-UK, and Barcelona-Spain) was undertaken. All adult patients, who underwent LT since the inception of the program to December 31, 2010, and survived at least 5 years since their LT were included. Patient survival was the primary outcome. A total of 3682 patients who survived at least 5 years following LT (long-term survivors) were included. Overall, median age at LT was 52 years (IQR 44-58); 53.1% were males; and 84.6% were Caucasians. A total of 49.4% (n=1820) died during a follow-up period of 36,828 person-years (mean follow-up 10y). A total of 80.2% (n=1460) of all deaths were premature deaths. Age-standardized all-cause mortality as compared to general population was 3 times higher for males and 5 times higher for females. On adjusted analysis, besides older recipients and older donors, predictors of long-term mortality were malignancy, cardiovascular disease, and dialysis. Implementation of strategies such as noninvasive cancer screening, minimizing immunosuppression, and intensive primary/secondary cardiovascular prevention could further improve survival.

Citation

Palaniyappan, N., Peach, E., Pearce, F., Dhaliwal, A., Campos-Varela, I., Cant, M. R., Dopazo, C., Trotter, J., Divani-Patel, S., Hatta, A. A., Hopkins, L., Testa, G., Bilbao, A., Kasmani, Z., Faloon, S., Mirza, D. F., Klintmalm, G. B., Bilbao, I., Asrani, S. K., Rajoriya, N., & Aravinthan, A. D. (2024). Long-term outcomes (beyond 5 years) of liver transplant recipients--a transatlantic multicenter study. Liver Transplantation, 30(2), 170-181. https://doi.org/10.1097/LVT.0000000000000244

• Journal Article Type: Article
• Acceptance Date: Jul 9, 2023
• Online Publication Date: Aug 18, 2023
• Publication Date: Feb 1, 2024
• Deposit Date: Jul 25, 2023
• Publicly Available Date: Aug 19, 2024
• Journal: Liver Transplantation
• Print ISSN: 1527-6465
• Electronic ISSN: 1527-6473
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 30
• Issue: 2
• Pages: 170-181
• DOI: https://doi.org/10.1097/LVT.0000000000000244
• Keywords: Transplantation; Hepatology; Surgery
• Public URL: https://nottingham-repository.worktribe.com/output/23476905
• Publisher URL: https://journals.lww.com/lt/abstract/9900/long_term_outcomes__beyond_5_years__of_liver.232.aspx
• Additional Information: This is the peer reviewed version of the following article: Palaniyappan, Naaventhan1,2; Peach, Emily3; Pearce, Fiona1,3; Dhaliwal, Amritpal4; Campos-Varela, Isabel5,6; Cant, Matthew R.4; Dopazo, Cristina7; Trotter, James8; Divani-Patel, Sapna4; Hatta, Ayiesha AZ4; Hopkins, Laurence4; Testa, Giuliano8; Bilbao, Angela7; Kasmani, Zain4; Faloon, Sarah4; Mirza, Darius F4,9; Klintmalm, Goran B8; Bilbao, Itxarone7; Asrani, Sumeet K8; Rajoriya, Neil4,10; Aravinthan, Aloysious D1,2. Long-term outcomes (beyond 5 years) of liver transplant recipients - a transatlantic multicentre study. Liver Transplantation ():10.1097/LVT.0000000000000244, August 18, 2023. , which has been published in final form at 10.1097/LVT.0000000000000244