OPTN/SRTR 2012 Annual Data Report: Liver

Abstract

When I awoke from surgery three and a half days later, while still on life support I spoke my first words, " She was younger than I." My surgeon teared up, " And she has three children!" I have had normal liver functions for the past seven years thanks to my 44-year old donor.Ronald, liver recipient liver ABSTRACT Liver transplant in the US remains a successful life-saving procedure for patients with irreversible liver disease. In 2012, 6256 adult liver transplants were performed, and more than 65,000 people were living with a transplanted liver. The number of adults who registered on the liver transplant waiting list decreased for the first time since 2002; 10,143 candidates were added, compared with 10,359 in 2011. However, the median waiting time for active wait-listed adult candidates increased, as did the number of candidates removed from the list because they were too sick to undergo transplant. The overall deceased donor transplant rate decreased to 42.3 per 100 patient-years, and varied geographically from 18.9 to 228.0 per 100 patient-years. Graft survival continues to improve, especially for donation after circulatory death livers. The number of new active pediatric candidates added to the waiting list also decreased. Almost 75% of pediatric candidates listed in 2009 underwent transplant within 3 years; the 2012 rate of deceased donor transplants among active pediatric wait-listed candidates was 136 per 100 patient-years. Graft survival for deceased donor pediatric transplants was 92.8% at 30 days. Medicare paid for some or all of the care for more than 30% of liver transplants in 2010.

Review on immunosuppression in liver transplantation

“…Maintenance of immunosuppression Starting 10-15 mg/kg per day divided every 12 h and adjust to the desired (C2) level Mycophenolate mofetil (Cellcept ® , Myfortic ® ) [60] Anti-metabolite Maintenance of immunosuppression, treatment of rejection Variable doses may be desired in any individual case Azathioprine (Imuran ® ) [65] Anti-metabolite Maintenance of immunosuppression Variable, maintenance dose may be 1.5-2.5 mg/kg per day, needs to be adjusted for adverse side effects Sirolimus (Rapamune ® ) [48,68,71] [44][45][46] T cell depleting monoclonal antibody…”

The Impact of Infection on Chronic Allograft Dysfunction and Allograft Survival After Solid Organ Transplantation

“…Allograft survival after transplantation has improved substantially over the past few decades (1,2). This is due, on the one hand, to enhanced immunosuppressive regimens that have reduced acute rejection rates (3).…”

Liver transplant outcomes using ideal donation after circulatory death livers are superior to using older donation after brain death donor livers

“…(1)(2)(3)(4) One method for increasing the number of transplantable organs has been to use organs from patients who die after circulatory death. (5)(6)(7)(8)(9) Accordingly, large increases in the number of transplantable kidneys have resulted from donation after circulatory death (DCD) protocols.…”