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KMID : 0361120220360010045
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Korean Journal of Transplantation
2022 Volume.36 No. 1 p.45 ~ p.53
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Twenty-year longitudinal follow-up after liver transplantation: a single-center experience with 251 consecutive patients
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Kim Min-Jae
Hwang Shin
Ahn Chul-Soo
Moon Deok-Bog
Ha Tae-Yong
Song Gi-Won
Jung Dong-Hwan
Park Gil-Chun
Kim Ki-Hun
Namgoong Jung-Man
Kang Woo-Hyoung
Yoon Young-In
Cho Hwui-Dong
Na Byeong-Gon
Kim Sang-Hoon
Lee Sung-Gyu
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Abstract
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Background: The outcomes of liver transplantation (LT) have improved, but actual 20-year survival data have rarely been presented.
Methods: Longitudinal follow-up data of 20-year LT survivors were retrospectively analyzed. The LT database of our institution was searched to identify patients who underwent primary LT from January 2000 to December 2001. The study cohort of 251 patients was divided into three groups: 207 adults who underwent living donor LT (LDLT), 22 adults who underwent deceased donor LT (DDLT), and 22 pediatric patients who underwent LT.
Results: Hepatitis B virus?associated liver cirrhosis and biliary atresia were the most common indications for adult and pediatric LT, respectively. Seven patients required retransplantation, including six who underwent DDLT and one who underwent LDLT. Twenty-two patients died within 3 months after LT and 69 died at later intervals. The overall survival rates at 1, 3, 5, 10, and 20 years were 86.4%, 79.6%, 77.7%, 72.8%, and 62.6%, respectively, in the adult LDLT group; 86.4%, 72.7%, 72.7%, 72.7%, and 68.2%, respectively, in the adult DDLT group; and 86.4%, 86.4%, 81.8%, 81.8%, and 77.3%, respectively, in the pediatric LT group (P=0.545). Common immunosuppressive regimens at 20 years included tacrolimus monotherapy, tacrolimus?mycophenolate dual therapy, cyclosporine monotherapy, and mycophenolate monotherapy.
Conclusions: The present study is the first report of actual 20-year survival data from a Korean high-volume LT center. The graft and patient survival outcomes reflected the early experiences of LT in our institution, with long-term outcomes being similar regardless of graft type and patient age.
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KEYWORD
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Living donor, Deceased donor, Donor shortage, Long-term follow-up, Perioperative mortality
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