Dr Kim Olthoff and colleagues from Philadelphia, USA determined whether the findings of the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) reflect the U.S. national experience.
In addition, the team defined risk factors for patient mortality and graft loss in living donor liver transplantation.
A2ALL previously identified risk factors for mortality after living donor liver transplantation, which included early center experience, older recipient age, and longer cold ischemia time.
The team evaluated living donor liver transplantation procedures at 9 A2ALL centers, and 67 non-A2ALL centers from 1998 through 2007 in the Scientific Registry of Transplant Recipients database.
The team identified potential predictors of time from transplantation to death or graft failure.
|There was no significant difference in overall mortality between centers|
The research team observed no significant difference in overall mortality between A2ALL and non-A2ALL centers.
Higher hazard ratios were associated with donor age, recipient age, serum creatinine levels, hepatocellular carcinoma or hepatitis C virus, intensive care unit stay or hospitalization versus home, earlier center experience, and a cold ischemia time more than 4.5 hours.
Except for center experience, the team found that risk factor effects between A2ALL and non-A2ALL centers were not significantly different.
Variables associated with graft loss were identified and showed similar trends.
Dr Olthoff's team commented, "Mortality and graft loss risk factors were similar in A2ALL and non-A2ALL centers."
"These analyses demonstrate that findings from the A2ALL consortium are relevant to other centers in the U.S. performing living donor liver transplantation."
"Conclusions and recommendations from A2ALL may help to guide clinical decision making."