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| Main Authors: | , , , , , , , , , |
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| Format: | Artículo Open Access |
| Published: |
Wiley
2025
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| Subjects: | |
| Online Access: | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70349 |
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Table of Contents:
- Survival Outcomes of Liver Transplantation Amid Rising Recipient and Donor Risk Profiles Eishan Ashwat Francis J. Spitz Abiha Abdullah Charbel Elias Jason Mail‐Anthony Sabin Subedi Godwin Packiaraj Timothy Fokken Shwe Han Michele Molinari Clinical Transplantation ABSTRACT Background Advances in liver transplantation (LT) have improved recipients’ short‐term survival. Whether similar gains extend to long‐term outcomes remains unclear. Methods We conducted a retrospective analysis of adult, first‐time LTs performed in the United States from 2002 to 2018, with follow‐up through December 31, 2023. Patients were grouped into three eras: 2002–2007, 2008–2013, and 2014–2018. Exclusions were ABO‐incompatible transplants, multivisceral or split grafts, and non‐hepatocellular carcinoma malignancies. Survival was estimated with Kaplan–Meier methods; Cox proportional hazards models adjusted for primary indication, sex, Liver Transplant Risk Score (LTRS), and Donor Risk Index (DRI). Results Among 82,696 recipients, 23,656 underwent LT in 2002–2007, 29,355 in 2008–2013, and 29,685 in 2014–2018. Despite increasing LTRS and DRI over time, mortality was significantly lower in 2014–2018 than in earlier eras at 90 days, 1 year, and 5 years (all p < 0.001). Long‐term survival improved across all LTRS strata except LTRS ≥ 7. Relative to 2002–2007, adjusted hazards for death were 0.89 (95% CI, 0.87–0.92; p < 0.001) in 2008–2013 and 0.67 (95% CI, 0.64–0.69; p < 0.001) in 2014–2018. Conclusions Despite rising recipient complexity and broader use of higher‐risk donors, both short‐ and long‐term LT survival improved in the United States over the past two decades. 10.1111/ctr.70349 http://creativecommons.org/licenses/by-nc-nd/4.0/