Korean J Transplant.  2022 Mar;36(1):45-53. 10.4285/kjt.21.0031.

Twenty-year longitudinal follow-up after liver transplantation: a single-center experience with 251 consecutive patients

• Kim M
• Hwang S
• Ahn CS
• Moon DB
• Ha TY
• Song GW
• Jung DH
• Park GC
• Kim KH
• Namgoong JM
• Kang WH
• Yoon YI
• Cho HD
• Na BG
• Kim SH
• Lee SG

• KMID: 2527897
• DOI: http://doi.org/10.4285/kjt.21.0031

Abstract

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.

Keyword

Living donor; Deceased donor; Donor shortage; Long-term follow-up; Perioperative mortality

Figure

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  Fig. 1 Kaplan-Meier analysis of graft (A) and patient (B) survival curves stratified by graft type and patient age. LT, liver transplantation; DDLT, deceased donor liver transplantation; LDLT, living donor liver transplantation.

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  Fig. 2 Relationship between the daily dosage of immunosuppressants and their trough concentration in liver transplant recipients who were administered tacrolimus (A) or cyclosporine (B) monotherapy.

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