Survival following simultaneous liver-lung versus liver alone transplantation: Results of the US national experience

Academic Article

Abstract

  • Background: There are little data to compare the post-transplant survival between lung-liver transplant (LLT) and liver-alone recipients. This study was undertaken to compare survival between LLT and liver-alone transplant. Methods: UNOS data for patients undergoing LLT from 2002 to 2017 was analyzed. LLT recipients (n = 81) were matched 1:4 to liver-alone recipients (n = 324) by propensity score and patient survival was compared in the matched cohorts. Results: Unadjusted 1, 3, and 5-year patient survival in the matched cohort was significantly worse in the LLT (82.5%, 72.2%, and 62.2%) versus liver-alone (92.2%, 82.8%, and 80.9%; p = 0.005). This difference persisted after adjusting for covariates with residual imbalance (HR 2.05, 95% CI 1.37–3.08; p = 0.001). Conclusion: LLT has significantly worse survival than liver-alone transplant. With an increasing organ shortage, medical necessity criteria such as those developed for simultaneous liver-kidney transplantation should be developed for simultaneous lung-liver transplants to assure liver allografts are only allocated when truly needed.
  • Digital Object Identifier (doi)

    Author List

  • Purvis J; McLeod C; Smith B; Orandi BJ; Kale C; Goldberg DS; Eckhoff DE; Locke JE; Cannon RM
  • Start Page

  • 813
  • End Page

  • 818
  • Volume

  • 222
  • Issue

  • 4