TABLE 3.
Outcomes on the LT Waiting List for HCC Patients by Region and MELD Exception Listing Year
| Overall (n = 14,320) | LWR (n = 4764) | MWR (n = 6134) | SWR (n = 3422) | P Value | |
|---|---|---|---|---|---|
| Dropout due to death/delisting | 2163 (15.1) | 1028 (21.6) | 882 (14.4) | 253 (7.4) | <0.001 |
| Median time to dropout (months) | <0.001 | ||||
| Overall | 5.6 (2.7–10.7) | 7.2 (3.3–12.9) | 5.2 (2.5–9.3) | 3.0 (1.3–5.5) | |
| Listed 2005–2009 | 5.0 (2.3–10.1) | 6.4 (3.1–13.3) | 4.0 (1.9–8.5) | 2.7 (1.0–5.1) | |
| Listed 2010–2014 | 6.0 (3.0–11.0) | 7.4 (3.5–12.9) | 5.6 (3.1–9.9) | 3.1 (1.3–5.7) | |
| Cumulative probability of dropout (95% CI) | <0.001 | ||||
| Within 12 months, % | |||||
| Overall | 12.7 (12.1–13.3) | 16.3 (15.2–17.4) | 13.1 (12.3–14.0) | 6.9 (6.1–7.8) | |
| Listed 2005–2009 | 9.8 (9.0–10.6) | 13.1 (11.6–14.6) | 9.7 (8.6–11.0) | 5.3 (4.2–6.5) | |
| Listed 2010–2014 | 14.9 (14.1–15.7) | 18.9 (17.4–20.5) | 15.5 (14.3–16.8) | 8.2 (7.0–9.5) | |
| Within 24 months, % | |||||
| Overall | 16.1 (15.4–16.7) | 22.5 (21.3–23.8) | 15.7 (14.8–16.7) | 7.7 (6.8–8.7) | |
| Listed 2005–2009 | 11.6 (10.8–12.5) | 16.5 (14.9–18.3) | 10.9 (9.6–12.2) | 5.8 (4.6–7.1) | |
| Listed 2010–2014 | 19.5 (18.6–20.4) | 27.3 (25.5–29.2) | 19.2 (17.8–20.6) | 9.3 (8.0–10.7) | |
| LT | 10,399 (72.6) | 2891 (60.7) | 4465 (72.8) | 3043 (88.9) | <0.001 |
| Laboratory MELD at LT | 0.22 | ||||
| MELD | 12 (9–15) | 12 (9–16) | 12 (9–16) | 12 (9–15) | 0.003 |
| Laboratory MELD at LT ≥ 15 | 3144 (30.3) | 927 (32.1) | 1363 (30.6) | 854 (28.1) | <0.001 |
| Laboratory MELD at LT ≥ 20 | 1185 (11.4) | 408 (14.1) | 538 (12.1) | 239 (7.9) | |
| DRI | 1.39 (1.13–1.69) | 1.45 (1.17–1.78) | 1.38 (1.12–1.67) | 1.34 (1.11–1.63) | <0.001 |
| DRI > 1.5 | 4156 (40.0) | 1344 (46.5) | 1742 (29.0) | 1070 (35.2) | <0.001 |
| DRI > 1.8 | 1858 (17.9) | 669 (23.1) | 739 (16.6) | 450 (14.8) | <0.001 |
| Donor age | <0.001 | ||||
| <40 years | 4404 (42.4) | 1196 (41.4) | 1835 (41.1) | 1373 (45.1) | |
| 40–49 years | 2013 (19.4) | 550 (19.0) | 874 (19.6) | 589 (19.4) | |
| 50–59 years | 2161 (20.8) | 574 (19.8) | 927 (20.8) | 660 (21.7) | |
| 60–69 years | 1315 (12.6) | 381 (13.2) | 592 (13.3) | 342 (11.2) | |
| ≥70 years | 506 (4.9) | 190 (6.6) | 237 (5.3) | 79 (2.6) | |
| Donation after circulatory death | 637 (6.1) | 193 (6.7) | 305 (6.8) | 139 (4.6) | <0.001 |
| Cold ischemia time, hours | 6.2 (5.0–8.0) | 6.6 (5.1–8.5) | 6.2 (5.0–8.0) | 5.9 (4.7–7.2) | <0.001 |
| Time to transplant, months | <0.001 | ||||
| Overall | 3.8 (1.4–7.8) | 7.7 (4.0–13.3) | 4.2 (1.7–7.7) | 1.6 (0.6–3.2) | |
| Listed 2005–2009 | 2.5 (0.9–5.4) | 5.6 (2.9–9.2) | 2.6 (0.9–4.9) | 1.0 (0.4–2.0) | |
| Listed 2010–2014 | 5.4 (2.4–10.4) | 11.6 (6.3–15.9) | 6.4 (3.4–10.2) | 2.3 (1.0–4.0) | |
| HCC MELD exception at LT | <0.001 | ||||
| Overall | 25 (22–28) | 28 (25–31) | 25 (22–28) | 22 (22–25) | |
| Listed 2005–2009 | 22 (22–25) | 25 (25–29) | 22 (22–25) | 22 (22–22) | |
| Listed 2010–2014 | 25 (22–29) | 31 (28–33) | 28 (25–29) | 22 (22–25) | |
| Cumulative probability of transplant (95% CI) | <0.001 | ||||
| Within 12 months, % | |||||
| Overall | 66.4 (65.6–67.2) | 44.9 (43.5–46.4) | 70.0 (68.8–71.2) | 90.3 (89.2–91.3) | |
| Listed 2005–2009 | 78.7 (77.7–79.8) | 63.2 (61.0–65.3) | 83.7 (82.1–85.1) | 92.6 (91.2–93.9) | |
| Listed 2010–2014 | 57.2 (56.1–58.3) | 30.4 (28.6–32.3) | 60.3 (58.6–61.9) | 88.5 (86.9–89.9) | |
| Within 24 months, % | |||||
| Overall | 78.8 (78.0–79.5) | 68.3 (66.8–69.7) | 80.1 (79.0–81.2) | 90.9 (89.9–91.9) | |
| Listed 2005–2009 | 83.9 (82.9–84.8) | 74.9 (72.9–76.8) | 86.0 (84.5–87.4) | 92.9 (91.5–94.2) | |
| Listed 2010–2014 | 75.1 (74.0–76.1) | 63.3 (61.2–65.3) | 76.0 (74.4–77.5) | 89.4 (87.8–90.7) | |
| 3-year post-LT survival | 0.02 | ||||
| Overall | 80.0 (79.2–80.8) | 81.1 (79.5–82.7) | 80.1 (78.7–81.3) | 78.9 (77.3–80.5) | Not significant* |
| Listed 2005–2009 | 78.8 (77.6–79.9) | 80.0 (77.8–82.0) | 78.7 (76.8–80.4) | 77.6 (75.2–79.8) | |
| Listed 2010–2014 | 81.3 (80.0–82.5) | 82.3 (79.6–84.7) | 81.6 (79.6–83.3) | 80.2 (77.8–82.3) |
NOTE: Data are given as n (%) or median (IQR). LWR is regions 1, 5, and 9; MWR is regions 2, 4, 6, 7, and 8; and SWR is regions 3, 10, and 11.
*
All P values >0.05 for post-LT survival comparisons between listing eras both overall and when stratified by wait region.