Living vs. Deceased Donor Liver Transplantation Provides Comparable Recovery...

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http://onlinelibrary.wiley.com/doi/10.1111/ajt.12975/abstract

Living vs. Deceased Donor Liver Transplantation Provides Comparable Recovery of Renal Function in Patients With Hepatorenal Syndrome: A Matched Case–Control Study
N. Goldaracena1, M. Marquez1, N. Selzner2, V. N. Spetzler1, M. S. Cattral1, P. D. Greig1, L. Lilly2, I. D. McGilvray1, G. A. Levy2, A. Ghanekar1, E. L. Renner2, D. R. Grant1 andM. Selzner1,*
DOI: 10.1111/ajt.12975
American Journal of Transplantation
Early View (Online Version of Record published before inclusion in an issue)

Abstract

Outcomes of living versus deceased donor liver transplantation in patients with chronic liver disease and hepatorenal syndrome (HRS) was compared using a matched pair study design. Thirty patients with HRS receiving a live donor liver transplantation (LDLT) and 90 HRS patients receiving a full graft deceased donor liver transplantation (DDLT) were compared. LDLT versus DDLT of patients with HRS was associated with decreased peak aspartate aminotransferase levels (339 ± 214 vs. 935 ± 1253 U/L; p = 0.0001), and similar 7-day bilirubin (8.42 ± 7.89 vs. 6.95 ± 7.13 mg/dL; p = 0.35), and international normalized ratio levels (1.93 ± 0.62 vs. 1.78 ± 0.78; p = 0.314). LDLT vs. DDLT had a decreased intensive care unit (2 [1–39] vs. 4 [0–93] days; p = 0.004), and hospital stay (17 [4–313] vs. 26 [0–126] days; p = 0.016) and a similar incidence of overall postoperative complications (20% vs. 27%; p = 0.62). No difference was detected between LDLT and DDLT patients regarding graft survival at 1 (80% vs. 82%), at 3 (69% vs. 76%) and 5 years (65% vs. 76%) (p = 0.63), as well as patient survival at 1 (83% vs. 82%), 3 (72% vs. 77%) and 5 years (72% vs. 77%) (p = 0.93). The incidence of chronic kidney disease post-LT (10% vs. 6%; p = 0.4) was similar between both groups. LDLT results in identical long-term outcome when compared with DDLT in patients with HRS.