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Long-term survival after liver transplantation in 4,000 consecutive patients at a single center

Jain, A and Reyes, J and Kashyap, R and Dodson, SF and Demetris, AJ and Ruppert, K and Abu-Elmagd, K and Marsh, W and Madariaga, J and Mazariegos, G and Geller, D and Bonham, CA and Gayowski, T and Cacciarelli, T and Fontes, P and Starzl, TE and Fung, JJ (2000) Long-term survival after liver transplantation in 4,000 consecutive patients at a single center. Annals of Surgery, 232 (4). 490 - 500. ISSN 0003-4932

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Objective: To evaluate the long-term survival outcomes of a large cohort of liver transplant recipients and to identify static and changing factors that influenced these outcomes over time. Summary Background Data: Liver transplantation has been accepted as a therapeutic option for patients with end-stage liver disease since 1983, with continual improvements in patient survival as a result of advances in immunosuppression and medical management, technical achievements, and improvements in procurement and preservation. Although many reports, including registry data, have delineated short-term factors that influence survival, few reports have examined factors that affect long-term survival after liver transplantation. Methods: Four thousand consecutive patients who underwent liver transplantation between February 1981 and April 1998 were included in this analysis and were followed up to March 2000. The effect of donor and recipient age at the time of transplantation, recipient gender, diagnosis, and year of transplantation were compared. Rates of retransplantation, causes of retransplantation, and cause of death were also examined. Results: The overall patient survival for the entire cohort was 59%; the actuarial 18-year survival was 48%. Patient survival was significantly better in children, in female recipients, and in patients who received transplants after 1990. The rates of retransplantation for acute or chronic rejection were significantly lower with tacrolimus-based immunosuppression. The risk of graft failure and death was relatively stable after the first year, with recurrence of disease, malignancies, and age-related complications being the major factors for loss. Conclusion: Significantly improved patient and graft survival has been observed over time, and graft loss from acute or chronic rejection has emerged as a rarity. Age-related and disease-related causes of graft loss represent the greatest threat to long-term survival.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Jain, A
Reyes, J
Kashyap, R
Dodson, SF
Demetris, AJ
Ruppert, Kruppertk@pitt.eduRUPPERTK
Abu-Elmagd, K
Marsh, W
Madariaga, J
Mazariegos, G
Geller, Ddageller@pitt.eduDAGELLER
Bonham, CA
Gayowski, T
Cacciarelli, T
Fontes, P
Starzl, TEtes11@pitt.eduTES11
Fung, JJ
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 16 October 2000
Date Type: Publication
Journal or Publication Title: Annals of Surgery
Volume: 232
Number: 4
Page Range: 490 - 500
DOI or Unique Handle: 10.1097/00000658-200010000-00004
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0003-4932
Other ID: uls-drl:31735062120369, Starzl CV No. 2124
Date Deposited: 08 Apr 2010 17:36
Last Modified: 02 Feb 2019 15:55


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