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Long-term patient and retransplantation-free survival by selected recipient and donor characteristics: an update from the Pitt-UNOS Liver Transplant Registry.

CENTERS
Between 1988 and 1996, the total number of liver transplantations performed in the United States more than doubled, and the number of centers performing liver transplantations increased from 58 to 106. The yearly net gain in number of centers has slowed substantially in recent years, and the reduced differences in volume per center reported previously has continued through 1996.


SURVIVAL AMONG PEDIATRIC RECIPIENTS
The estimated cumulative probability of a pediatric recipient surviving for 9 years following transplantation was .71, and surviving for 9 years without retransplantation was .58. In general, few deaths or retransplantations were observed more than 5 years following the initial transplantation. Factors independently associated with patient and retransplantation-free survival among children were year of transplantation, recipient age, location awaiting transplantation, primary liver disease, pre-LT serum creatinine, pre-LT bilirubin, and donor age. Recipient race and multiorgan transplantation were significantly associated with patient survival. Interestingly, of the 23 multi-organ recipients who survived at least 3 years, none died or required retransplantation.


SURVIVAL AMONG ADULT RECIPIENTS
The estimated cumulative probability of an adult recipient surviving for 9 years following transplantation was .55, and surviving for 9 years without retransplantation was .48. Though the one-year survival rate among adults was slightly better than among children, long-term survival was substantially worse. Factors independently associated with patient and retransplantation-free survival among adults were year of transplantation, recipient age, race, location awaiting transplantation, primary liver disease, pre-LT creatinine, pre-LT albumin, recipient HBsAg status, donor age, donor anti-CMV status, ABO match, and sex match. Pre-LT bilirubin was significantly associated with patient survival, and pre-LT prothrombin time was associated with retransplantation-free survival.