Life Expectancy after Liver Transplantation

By Liz Highleyman

Hepatitis C can cause long-term liver damage, including advanced cirrhosis and hepatocellular carcinoma, and is currently the most common indication for liver transplantation in the U.S. and Europe. Since the operation was pioneered in the 1960s, short-term survival rates have improved due to better surgical techniques and post-transplant medical management.

In the September 28, 2006 online edition of Gut, researchers reported on a study to assess the long-term survival, life expectancy, and life-years lost of adult liver allograft (donor liver) recipients.

Using the National Transplant Database maintained by U.K. Transplant -- which includes information on more than 3600 adult liver allograft recipients transplanted between 1985 and 2003 -- they analyzed data for all patients who survived more than 6 months after transplantation. Post-transplant survival was compared against national age- and sex-matched controls in the general population to assess life-years lost.

Results

The analysis cohort included 2702 adult liver allograft recipients.

After reaching the 6-month milestone, the estimated median survival time was 22.2 years (95% CI 19.3-25.6 years), compared with about 29 years for the general population of the same age.

For women, median post-transplant survival was 26 years, compared with 31 for the general population.

For men, median post-transplant survival was 18 years, compared with 27 for the general population.

There was an estimated loss of 7 life-years compared with the age- and sex-matched controls.

Patients aged 17-34 had the highest life expectancy: 28 years post-transplant.

Conclusion

In conclusion, the authors wrote, "Overall, female [liver] recipients have a longer life expectancy and lose fewer life-years than male recipients. While younger recipients have a longer life expectancy, they also lose more life-years. Those transplanted for cancer, hepatitis C virus infection, and alcoholic liver disease had the greatest loss of life-years."

They noted that while 1-year survival rates have increased over the years, "death rates beyond this period have remained more or less the same." This may be the case because, while surgery has improved, patients undergoing the procedure today include older and sicker individuals, and more "marginal" liver grafts are sometimes used due to the shortage of donated organs.

10/13/06

Reference
K Barber, J Blackwell, D Collett, and others. Life expectancy of adult liver allograft recipients in the UK. Gut. September 28, 2006 [Epub ahead of print]