Liver and intestine transplantation in the United States 1998-2007

C. L. Berg, D. E. Steffick, E. B. Edwards, J. K. Heimbach, J. C. Magee, W. K. Washburn, G. V. Mazariegos

Research output: Contribution to journalReview article

144 Scopus citations

Abstract

Liver transplantation numbers in the United States remained constant from 2004 to 2007, while the number of waiting list candidates has trended down. In 2007, the waiting list was at its smallest since 1999, with adults ≥50 years representing the majority of candidates. Noncholestatic cirrhosis was most commonly diagnosed. Most age groups had decreased waiting list death rates; however, children <1 year had the highest death rate. Use of liver allografts from donation after cardiac death (DCD) donors increased in 2007. Model for end-stage liver disease (MELD)/pediatric model for end-stage liver disease (PELD) scores have changed very little since 2002, with MELD/PELD <15 accounting for 75% of the waiting list. Over the same period, the number of transplants for MELD/PELD <15 decreased from 16.4% to 9.8%. Hepatocellular carcinoma exceptions increased slightly. The intestine transplantation waiting list decreased from 2006, with the majority of candidates being children <5 years old. Death rates improved, but remain unacceptably high. Policy changes have been implemented to improve allocation and recovery of intestine grafts to positively impact mortality. In addition to evaluating trends in liver and intestine transplantation, we review in depth, issues related to organ acceptance rates, DCD, living donor transplantation and MELD/PELD exceptions.

Original languageEnglish (US)
Pages (from-to)907-931
Number of pages25
JournalAmerican Journal of Transplantation
Volume9
Issue number4 PART 2
DOIs
StatePublished - Apr 1 2009

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Keywords

  • Deceased donors
  • Living donors
  • Organ donation
  • Organ procurement
  • Scientific Registry of Transplant Recipients

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

Berg, C. L., Steffick, D. E., Edwards, E. B., Heimbach, J. K., Magee, J. C., Washburn, W. K., & Mazariegos, G. V. (2009). Liver and intestine transplantation in the United States 1998-2007. American Journal of Transplantation, 9(4 PART 2), 907-931. https://doi.org/10.1111/j.1600-6143.2009.02567.x