Long-term outcomes (beyond 5 years) of liver transplant recipients - a transatlantic multicentre study

Abstract

The long-term (>5 y) outcomes following liver transplantation (LT) have not been extensively reported. The aim was to evaluate outcomes of LT recipients who have survived the first 5 years. A multicentre retrospective analysis of prospectively collected data from 3 high volume LT centres (Dallas-USA, Birmingham-UK, and Barcelona-Spain) was undertaken. All adult patients, who underwent LT since the inception of the programme to 31 December 2010, and survived at least 5 years since their LT were included. Patient survival was the primary outcome. A total of 3682 patients who survived at least 5 years following LT (long-term survivors) were included. Overall, median age at LT was 52 years (IQR 44-58); 53.1% were males; and 84.6% were Caucasians. 49.4% (n=1820) died during a follow-up period of 36828 person-years (mean follow-up 10 y). 80.2% (n=1460) of all deaths were premature deaths. Age-standardised all-cause mortality as compared to general population was 3 times higher for males and 5 times higher for females. On adjusted analysis, besides older recipients and older donors, predictors of long-term mortality were malignancy, CVD and dialysis. Implementation of strategies such as non-invasive cancer screening, minimising immunosuppression and intensive primary/secondary cardiovascular prevention could further improve survival.