Table 2.
Studies comparing living-donor liver transplantation and deceased-donor liver transplantation in patients with hepatitis C cirrhosis.
| Author | Year | n (LDLT/DDLT) | MELD score (LDLT/DDLT) | Donor age (LDLT/DDLT) | Cold ischemia time (h) (LDL/DDLT) | Follow-up (mo) |
Histologic progression | Patient survival LDLT/DDLT (%) | Graft survival LDLT/DDLT (%) | Comments |
|---|---|---|---|---|---|---|---|---|---|---|
| Gaglio et al. [144] | 2003 | 68 (23/45) | 12.6/28* | NA | NA | 24 | NA | 87/89 | 87/85 | No difference in outcomes, increased risk of cholestatic hepatitis in LDLT |
| Garcia-Retortillo et al. [145] | 2004 | 117 (22/95) | 11 (5–24)/11 (2–28) | 31 (19–58)/47 (13–86)# | NA | 22 | Significantly severe in LDLT | NA | NA | Severe hepatitis C recurrence in LDLT |
| Thuluvath and Yoo [146] | 2004 | 619 (207/412) | NA | 35.8 ± 0.4/38.9 ± 18.1# | 3.9 ± 7.3/8.4 ± 4.5† | 24 | NA | 79/81 | 74/73 | Lower graft survival in LDLT |
| Humar et al. [85] | 2005 | 51 (12/39) | 17 (14–27)/24 (17–40)* | 37.7 ± 9.2/42.8 ± 16.2# | 10.2 ± 4.2/<1† | 28.3 | Significantly severe in DDLT | 92/90 | NA | LDLT may be at a low risk for HCV recurrence |
| Shiffman et al. [84] | 2004 | 76 (23/53) | 13.5 ± 1.1/16.2 ± 1.0 | 47.6 ± 2/47.8 ± 0.8 | NA | 36 | No difference | 79/82 | 76/82 | No difference in outcomes |
| Maluf et al. [86] | 2005 | 126 (29/97) | 13.2 ± 1.1/21 ± 0.8* | NA | 0.6 ± 0.2/7.5 ± 2.8† | 72 | NA | 67/70 | 64/69 | No difference in survival, more rejection in DDLT and biliary complications in LDLT |
| Russo et al. [87] | 2004 | 4234 (279/3955) | NA (TB, PT and Cre were significantly worse in DDLT) | 37/40# | 8.1/2.6† | 24 | NA | 83/81 | 72/75 | No difference in outcomes |
| Bozorgzadeh et al. [88] | 2004 | 100 (35/65) | 14.9 ± 4/15.9 ± 5.3 | 34.6 ± 9.7/49.2 ± 20.4 | NA | 39 | No difference | 89/75 | 83/64 | No difference in outcomes |
| Van Vlierberghe et al. [89] | 2004 | 43 (17/26) | 15 ± 9/15 ± 8 | 31 ± 8/48 ± 17 | 3.1 ± 1.3/11.1 ± 2.6† | 12 | No difference | No difference (Presented with only figure) | No difference (Presented with only figure) | No difference in outcomes in short-term |
| Schiano et al. [90] | 2005 | 26 (11/15) | 14 (9–19)/18 (10–31) P = 0.05 |
33 (20–54)/47 (13–73) | 0.6 (0.3–1.0)/10 (4.4–20)† | 24 | NA | 73/80 | 73/80 | No difference in survival, accelerated viral load increase in LDLT |
| Guo et al. [91] | 2006 | 67 (15/52) | 16.9 ± 6.9/19.0 ± 8.3 | NA | NA | 24 | No difference | 93/96 | 87/94 | No difference in outcomes |
| Terrault et al. [92] | 2007 | 275 (181/94) | 14 (6–40)/18 (7–40)* | 38 (19–57)/41 (9–72) | 0.8 (0.1–8)/6.7 (0.2–10)† | 36 | No difference | 74/82 | 68/80 | No significant difference in patient/graft survival in experienced LDLT centers |
| Schmeding et al. [93] | 2007 | 289 (20/269) | NA | 38.6 ± 15.2/44.2 ± 12 | NA | 60 | No difference | Better in DDLT (P = 0.011) | Better in DDLT (P = 0.006) | LDLT does not increase the risk and severity of HCV recurrence. No difference in patient/graft survival when HCC beyond Milan excluded. |
| Selzner et al. [94] | 2008 | 201 (46/155) | 14 (7–39)/17 (6–40) | 38 (19–59)/46 (11–79)# | 1.5 (0.5–4.9)/7.5 (1.1–16)† | 60 | Significantly severe in DDLT | 84/78 | 76/74 | Donor age, rather than transplant approach, affects the progression of HCV |
| Gallegos-Orozco et al. [39] | 2009 | 200 (32/168) | 14.6 ± 4.7/25.5 ± 5.9* | 35 ± 12/40 ± 16 P = 0.05 |
NA | 60 | No difference | 81/81 | NA | LDLT is a good option for HCV cirrhosis |
| Jain et al. [95] | 2011 | 100 (35/65) | 14.5 ± 3.9/16.8 ± 7.3* | 34.3 ± 9.3/47.2 ± 19.8# | 11 ± 3.1 in DDLT | 84 | Significantly severe in DDLT at all time points | 77/65 | 71/46 | Both patient/graft survival and histologic findings were better in LDLT |
*MELD score is significantly higher in DDLT.
#Donor age is significantly higher in DDLT.
†Cold ischemia time is significantly longer in DDLT.
Cre: creatinine; DDLT: deceased-donor liver transplantation; LDLT: living-donor liver transplantation; MELD: model for end-stage liver disease; NA: not available; PT: prothombin-time; TB: total bilirubin.