Factors that Influence Liver Transplant Survival

According to a study, three major factors drive the success or failure of liver trans1 plantation-donor age, the urgency of the recipient's need and the length of time a donated liver is cooled between procurement and transplant.

After analyzing data on all adult patients who had a liver transplant at Vanderbilt University Medical Center over a 12-year period, researchers there conclude that transplant and patient survival was increased when…

• The organ donor was younger than 60 years old.
  
• The liver cooling period (clinically called "cold ischemia time") was less than 12 hours.
  
• The patient was not deemed an "urgent recipient."
  

The Study

The researchers found that "five-year graft survival was 72% for people who received livers from donors younger than 60 years and 35% for those who received livers from donors 60 years or older," say the researchers. An organ cooling period of 12 hours or more was (also) associated with shorter five-year graft survival."

Based on these findings, they estimate that an organ from a young donor transplanted into a relatively healthy recipient within 12 hours of cooling "would have a probability of 75% of surviving for five years."

In contrast, an urgent-need patient receiving an organ from a donor 60 years of age or older, transplanted beyond the 12-hour cooling limit "would have only a 20% probability of surviving five years after the transplant."

Because of the large demand for liver transplants, livers that are less than optimum are being considered for possible transplant. Identifying the factors that have the greatest influence on patient survival rates could help increase the donor pool and shorten waiting times for liver transplantation

Each year in the US, approximately 2,000 people who have end-stage liver disease die while waiting for a suitable donor liver. In 2000, there were approximately 17,000 patients waiting for a liver transplant and approximately 5,000 liver transplantations.