Long Term Outcomes of Liver Transplantation For Patients With Autoimmune Hepatitis

Alswat, Khalid; Soliman, E. S.; Salih, Isam; Bashmail, Ahmed; Letierce, Alexia; Benmousa, Ali; Alghamdi, Saad; Bzeizi, Khalid; Alqahtani, Saleh A.; Shawkat, Mohamed; Broering, Dieter; Al–Hamoudi, Waleed

doi:10.1016/j.transproceed.2021.07.040

Cited by 1 publication

(2 citation statements)

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“…Their OS was found to be similar, and they found no significant risk associated with LDLT grafts on patient survival. In a large single-center study by Alswat et al, [26] there was also no difference in patient and graft survival when comparing LDLT and DDLT for AIH, mirroring our findings.…”

Section: Discussionsupporting

confidence: 89%

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Pursuing living donor liver transplantation improves outcomes of patients with autoimmune liver diseases: An intention-to-treat analysis

Jones,

Claasen,

Ivanics

et al. 2024

Liver Transplantation

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Background Living donor liver transplantation (LDLT) offers the opportunity to decrease waitlist time and mortality for patients with AILD; autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC). We compared the survival of patients with a potential live donor (pLDLT) on the waitlist vs. no potential live donor (pDDLT), on an intention-to-treat (ITT) basis. Methods Our retrospective cohort study investigated adults with AILD listed for liver transplant at our program between 2000 and 2021. The pLDLT group comprised recipients with a potential live donor. Otherwise, they were included in the pDDLT group. ITT survival was assessed from the time of listing. Results Of the 533 patients included, 244(43.8%) had a potential living donor. Waitlist dropout was higher for the pDDLT groups among all AILDs (pDDLT 85[29.4%] vs. pLDLT 9[3.7], p<0.001). The 1-, 3- and 5-year ITT survival rates were higher for pLDLT vs. pDDLT among all AILDs (95.7%vs.78.1%, 89.0%vs.70.1%, and 87.1%vs.65.5%, p<0.001). After adjusting for covariates, pLDLT was associated with a 38% reduction in the risk of death among the AILD cohort (HR:0.62, 95%CI:0.42-0.93[p<0.05]), and 60% among the PSC cohort (HR:0.40, 95%CI:0.22-0.74[p<0.05]). There were no differences in the 1-, 3- and 5-year post-transplant survival between LDLT and DDLT (AILD: 95.6%vs.92.1%, 89.9%vs.89.4%, and 89.1%vs. 87.1%, p=0.41). This was consistent after adjusting for covariates (HR: 0.97, 95%CI:0.56-1.68[p>0.9]). Conclusion Our study suggests that having a potential live donor could decrease the risk of death in patients with PSC on the waitlist. Importantly, the post-transplant outcomes in this population are similar between the LDLT and DDLT groups.

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Section: Discussionsupporting

confidence: 89%

“…Of the initial 533 patients in the study, 391 were transplanted, of which 212 (53.5%) patients underwent an LDLT and 179 (46.5%) underwent a DDLT (Figure 1). Patients who underwent DDLT had higher MELD scores than patients who underwent LDLT in the AILD (18 [IQR: 13,26]…”

Section: Patient Characteristics As-treated Analysismentioning

confidence: 99%