Survival following simultaneous liver-lung versus liver alone transplantation: Results of the US national experience - 16/09/21
Abstract |
Background |
There are little data to compare the post-transplant survival between lung-liver transplant (LLT) and liver-alone recipients. This study was undertaken to compare survival between LLT and liver-alone transplant.
Methods |
UNOS data for patients undergoing LLT from 2002 to 2017 was analyzed. LLT recipients (n = 81) were matched 1:4 to liver-alone recipients (n = 324) by propensity score and patient survival was compared in the matched cohorts.
Results |
Unadjusted 1, 3, and 5-year patient survival in the matched cohort was significantly worse in the LLT (82.5%, 72.2%, and 62.2%) versus liver-alone (92.2%, 82.8%, and 80.9%; p = 0.005). This difference persisted after adjusting for covariates with residual imbalance (HR 2.05, 95% CI 1.37–3.08; p = 0.001).
Conclusion |
LLT has significantly worse survival than liver-alone transplant. With an increasing organ shortage, medical necessity criteria such as those developed for simultaneous liver-kidney transplantation should be developed for simultaneous lung-liver transplants to assure liver allografts are only allocated when truly needed.
Le texte complet de cet article est disponible en PDF.Highlights |
• | There are no current criteria to guide allocation of lung-liver transplants. |
• | Lung-liver recipients often have compensated liver disease with a low MELD score. |
• | Survival after lung-liver transplant is inferior to that after liver transplant alone. |
• | Necessity criteria are needed to ensure liver-lung transplants are truly warranted. |
Keywords : Liver transplantation, Liver allocation, Simultaneous thoracic abdominal transplantation, Propensity matching
Plan
Vol 222 - N° 4
P. 813-818 - octobre 2021 Retour au numéro
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