Long-term outcome after living donor liver transplantation compared to donation after brain death in autoimmune liver diseases: Experience from the European Liver Transplant Registry

Autor: Christophe Duvoux, Ahmet Coker, Krzysztof Zieniewicz, Seyed Ali Malek-Hosseini, Sezai Yilmaz, Arianeb Mehrabi, Melina Heinemann, Karim Boudjema, René Adam, Vincent Karam, Christoph Schramm, Peter Lodge, Darius F. Mirza, Marina Berenguer, Michael A. Heneghan, Andreas Paul, Koray Acarli, Ansgar W. Lohse, Johann Pratschke, Yaman Tokat, Jiri Fronek, Timur Liwinski
Přispěvatelé: University Hospital Hamburg-Eppendorf, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Hôpital Paul Brousse, Universitat de València (UV), Queens Elizabeth Hospital [Birmingham], Shiraz University of Medical Sciences [Iran] (SUMS), King's College Hospital (KCH), Leeds Teaching Hospitals NHS Trust, Charité Campus Virchow-Klinikum (CVK), CHU Pontchaillou [Rennes], Universitätsklinikum Essen [Universität Duisburg-Essen] (Uniklinik Essen), Medical University of Warsaw - Poland, Institute for Clinical and Experimental Medicine (IKEM), University of Heidelberg, Medical Faculty, Ege university, Inönü University, CHU Henri Mondor, Astellas PharmaAstellas Pharmaceuticals, NovartisNovartis, Institut Georges Lopez, SandozNovartis, CHU Henri Mondor [Créteil]
Rok vydání: 2021
Předmět:
Adult
Male
medicine.medical_specialty
Brain Death
Cirrhosis
Multivariate analysis
[SDV]Life Sciences [q-bio]
Medizin
living donor
Disease
Autoimmune hepatitis
inflammatory
030230 surgery
clinical research/practice
Gastroenterology
Primary sclerosing cholangitis
03 medical and health sciences
0302 clinical medicine
patient survival
Internal medicine
medicine
Primary Sclerosing Cholangitis
Living Donors
Immunology and Allergy
Risk-Factors
Humans
Pharmacology (medical)
Registries
Child
Retrospective Studies
Transplantation
business.industry
Liver Diseases
Hazard ratio
Graft Survival
Cohort
[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology
medicine.disease
3. Good health
Donation after brain death
Liver Transplantation
Treatment Outcome
030211 gastroenterology & hepatology
immune
Morbidity
Living donor liver transplantation
business
liver disease
liver transplantation/hepatology
Zdroj: American Journal of Transplantation
American Journal of Transplantation, Wiley, 2021, ⟨10.1111/ajt.16864⟩
American Journal of Transplantation, 2021, ⟨10.1111/ajt.16864⟩
ISSN: 1600-6143
1600-6135
Popis: Knowledge of living donor liver transplantation (LDLT) for autoimmune liver diseases (AILDs) is scarce. This study analyzed survival in LDLT recipients registered in the European Liver Transplant Registry with autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis (PSC) and the non-autoimmune disorder alcohol-related cirrhosis. In total, 29 902 individuals enrolled between 1998 and 2017 were analyzed, including 1003 with LDLT. Survival from >90 days after LDLT for AILDs in adults was 85.5%, 74.2%, and 58.0% after 5, 10, and 15 years. Adjusted for recipient age, sex, and liver transplantation era, adult PSC patients receiving LDLT showed increased mortality compared to donation after brain death (DBD) (hazard ratio [HR] = 1.95, 95% confidence interval [CI] = 1.36-2.80, p < .001). Pediatric PSC patients showed also increased mortality >90 days after LDLT compared to DBD (HR = 3.00, 95% CI 1.04-8.70, p = .043). Multivariate analysis identified several risk factors for death in adult PSC patients receiving LDLT including a male donor (HR = 2.49, p = .025). Adult PSC patients with LDLT versus DBD conferred increased mortality from disease recurrence (subdistribution hazard ratio [subHR] = 5.36, p = .001) and biliary complications (subHR = 4.40, p = .006) in multivariate analysis. While long-term outcome following LDLT for AILD is generally favorable, PSC patients with LDLT compared to DBD might be at increased risk of death.
Astellas Pharma; Novartis; Institut Georges Lopez; Sandoz
The Organ Sharing Organizations: the French ABM (Sami Djabbour), the Dutch NTS (Maaike de Wolf), the Eurotransplant Foundation (Marieke Van Meel), the Spanish RETH (Gloria de la Rosa), the UK-Ireland NHSBT (Michael Daynes), and the Scanditransplant (Ilse Duus Weinreich) are acknowledged for the data cross-check and sharing with the ELTR. The European Liver Transplant Registry is supported by a grant from Astellas Pharma, Novartis, Institut Georges Lopez, and Sandoz and receives logistical support from the Paul Brousse Hospital (AP-HP).
Databáze: OpenAIRE