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Living donor liver transplantation improves survival over deceased donor transplants
Date:9/27/2011

lowed for a mean of 4.6 years. Living donors of the study candidates were evaluated between February 2002 and August 2009the period following MELD-based liver allocation. DDLT recipients transplanted at study centers were obtained for comparison during the same time period.

Mortality for LDLT recipients was compared to mortality of candidates remaining on the waiting list or who received DDLT, with categories of MELD score lower or greater than 15, and HCC diagnosis. Researchers reported that of the potential LDLT recipients, 453 had MELD scores lower than 15 and 415 were greater than 15. Transplantation was performed on 712 candidates (406 LDLT; 306 DDLT), 83 died without transplant, and 73 remained without transplant at the final follow-up.

"We found that survival was significantly higher for candidates without HCC who underwent LDLT, rather than waiting for DDLT," concluded Dr. Berg. Results showed that LDLT recipients had a 56% lower mortality rate, and among candidates without HCC the mortality benefit was seen in both patients groupsthose with MELD scores above and below 15. However, researchers did not observe a similar survival benefit for candidates with HCC who had MELD scores lower than 15.

"Dr. Berg and colleagues have provided very valuable new insights that will help answer the important question of optimal time to transplant. However, this study group was comprised of candidates who were deemed appropriate for LDLT and was not a randomized trial," said Julie Heimbach, M.D., an Associate Professor of Surgery with the Mayo Clinic College of Medicine in Minnesota, in her editorial also published in this month's issue of Hepatology. "Future studies validating quality of life outcomes following LDLT compared to prolonged wait listing or DDLT would assist physicians in advising patients and families in timing of and donor options for liver transplantation."


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Contact: Dawn Peters
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Wiley-Blackwell
Source:Eurekalert

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