Liver Transplantation has advanced over the past three decades, with one-year survival rates improving 25%. Survival rates for those transplanted has increased to remarkable levels, but survival from the time of listing may not be as revolutionary.
Kaplan-Meier with log-rank test as well as Cox regression analysis was used to retrospectively analyze 211,610 adults listed for LT and 116,299 adult transplant recipients from 1987 to 2016. Our primary endpoints were survival from time of listing to waitlist death or posttransplant death.
One-year survival following LT improved dramatically (68% in 1987-1988 vs. 93% in 2016, p <0.001). There was no improvement in one-year intent-to-treat survival: 78.4% for those listed in 1987 and 81.8% for those listed in 2016 (p = 0.1). Also observed were decreases in the percentage of transplanted candidates from 74.8% in 1987-1988 to 54.7% in 2016 (p <0.001) and increased one-year wait-list mortality from 12.5% in 1987-1988 to 22.6% in 2016 (p = 0.002).
As transplant rate has decreased while waitlist mortality has increased, no improvements have been made in intent-to-treat survival of patients listed for transplant over the past three decades. We speculate this observation to be resultant of a relative donor shortage outpaced by waitlist growth.
Liver Transplantation has experienced vast increases in survival rates over the past three decades, however, due to an increased donor supply outpaced by waitlist growth, the rate of transplantation has decreased significantly while the waitlist mortality has increased, leading to no improvement in one-year intent-to-treat survival rates. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

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